Michael Kennedy, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

171806 Issued in NY

Practice address

17 Southdown Rd
Huntington, NY 11743-2538

Phone

(631) 923-2139

Fax

(631) 923-2140

NPI assigned

Nov 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency MedicineAlso: Family Practice

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

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.

• CLK Medical Consulting, PLLC

  • Sports Medicine (Emergency Medicine) Physician
  • Huntington, NY
  • NPI 1891084612
  Medicare reassignment NPD Authorized official
• North Shore Long Island Jewish Healthcare

  • Cardiovascular Disease Physician
  • Westbury, NY
  • NPI 1215019500

  Emergency Medicine

  Medicare reassignment NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Emergency Medicine

  Medicare reassignment NPD
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD
• North Shore Long Island Jewish Health Care Inc

  • Internal Medicine Physician
  • New York, NY
  • NPI 1912338385
  NPD
• North Shore University Hospital at Plainview

  • Emergency Medicine Physician
  • Plainview, NY
  • NPI 1649355058
  NPD (past)
• Hilton Head Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Hilton Head Island, SC
  • NPI 1326047176
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1982778486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SOUTHDOWN RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432538",
            "telephone_number": "631-923-2139",
            "fax_number": "631-923-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 SOUTHDOWN RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432538",
            "telephone_number": "631-923-2139",
            "fax_number": "631-923-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "171806",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS-006765-E",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "02524",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A18353",
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "SC",
            "license": "420",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01071058",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beth-Anne Keating, N.P.
• Christine M Keil
• Colleen Kelly
• Sandra C Kelly, LCSW-R
• Frances Kennedy
• Meredith Kennelly
• Meggan Jo Kent, FNP-BC
• Robin Kerns, LMT
• Jeannine Kerr
• Robert Gawley Kerr, M.D.

• Emergency Medicine Physician in Huntington, NY
• Providers in Huntington, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.