Paul Kennelly, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

MD 002445 Issued in NJ

Practice address

1749 Hooper Ave
Suite 101
Toms River, NJ 08753-8130

Phone

(732) 255-8805

Fax

(732) 255-8091

NPI assigned

Aug 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Liberty Foot &Ankle Center

  • Foot & Ankle Surgery Podiatrist
  • Forked River, NJ
  • NPI 1952442550

  O20100930043415

  Same enrollment

Specialty

Podiatry

Education

Temple University School of Podiatric Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Medical Center Hospital, Toms River, NJ, CCN 310041

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Community Medical Center Inc

  • General Acute Care Hospital
  • Toms River, NJ
  • NPI 1013010917

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992713192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1749 HOOPER AVE",
            "address_2": "SUITE 101",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087538130",
            "telephone_number": "732-255-8805",
            "fax_number": "732-255-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1749 HOOPER AVE",
            "address_2": "SUITE 101",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087538130",
            "telephone_number": "732-255-8805",
            "fax_number": "732-255-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNELLY",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "MD 002445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7541503",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trina Kennedy-Harjes
• Beth Anne Kennedy, M.P.T.
• Brian Kennedy, LPC
• Olivia Kennedy, LCSW
• Patricia Anne Kennedy, P.T.
• Kensington Manor Care Center
• Kensington Manor Care Center
• Jenilee Kerchefsky
• Harvey Lee Kerker, O.D.
• Judith M. Kern, APNC

• All providers in Toms River, NJ
• Foot & Ankle Surgery Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.