Individual provider Active NPI

Nicholas J Kenhart, FNP

  • Family Nurse Practitioner
  • Vestal, NY
National Provider Identifier
1972815462
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F336413 Issued in NY
Practice address
4417 Vestal Pkwy E
Vestal, NY 13850-3556
Phone
(607) 770-7365
Fax
(607) 729-5882
NPI assigned
Jul 13, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F336413 NY Primary

Addresses

Primary practice location

4417 Vestal Pkwy E
Vestal, NY 13850-3556

Mailing address

346 Grand Ave
Johnson City, NY 13790-2580
Phone (607) 729-8156

Other identifiers 1

IdentifierTypeStateIssuer
03240475MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nicholaskenhartnp@lourdes-southside.medentdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110127000858 NY Practitioner - Nurse Practitioner 7719166354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

169 Riveride Dr
Binghamton, NY 13905-4246

65 Pennsylvania Ave
Suite 303
Binghamton, NY 13903-1651
Phone (607) 798-5953

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
336413NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Memorial Hospital Inc. Current Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Sep 30, 2017 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Sep 30, 2017 Accepting new patients
Twin Tier Pathology Associates, PC Current Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

65 Pennsylvania Ave
Binghamton, NY 13903
Phone (607) 723-5393

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

501 Reynolds Rd
Johnson City, NY 13790
Phone (607) 797-6071

Interoperability endpoints

  • Direct secure messaging: nkenhart196749@direct-guthrie.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1972815462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 GRAND AVE",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902580",
            "telephone_number": "607-729-8156",
            "fax_number": "607-729-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503556",
            "telephone_number": "607-770-7365",
            "fax_number": "607-729-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENHART",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-13",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03240475",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicholaskenhartnp@lourdes-southside.medentdirect.com",
            "affiliation": "N",
            "endpointDescription": "Lourdes Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "65 Pennsylvania Ave",
            "city": "Binghamton",
            "state": "NY",
            "country_code": "US",
            "postal_code": "139031651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.