Derek B Kennedy (NPI# 1396088571, PAC ID# 4082912670) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1396088571 |
| PAC ID by PECOS | 4082912670 |
| Professional Enrollment ID | I20180726001583 |
| Full Name | Derek B Kennedy |
| Organization Legal Name | EXIGENCE MEDICAL OF JAMESTOWN PLLC |
| Address |
207 Foote Ave Jamestown NY 14701-7077 |
| Phone Number | 7164870141 |
| Gender | M |
| Medical School | YALE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2013 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 8325208747 |
| Number of Group Practice Members | 17 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330223 | MASSENA MEMORIAL HOSPITAL |
| 330239 | UPMC CHAUTAUQUA WCA |
| 330044 | FAXTON-ST LUKE'S HEALTHCARE |
| 330245 | ST ELIZABETH MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 207 Foote Ave, Jamestown, NY 14701-7077 | 7164870141 | EXIGENCE MEDICAL OF JAMESTOWN PLLC |
| 1 Hospital Dr, Massena, NY 13662-1097 | 3157694236 | EMERGENCY PHYSICIAN SERVICES OF NEW YORK, P.C. |
| 1 Hospital Dr, Massena, NY 13662-1056 | 3157694200 | TOWN OF MASSENA |
| 214 King St, Ogdensburg, NY 13669-1142 | 3153933995 | EMERGENCY PHYSICIAN SERVICES OF NEW YORK, P.C. |
| Organization Legal Name | EXIGENCE MEDICAL OF JAMESTOWN PLLC |
| Physicians | 15 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Albert Eric Blair | Emergency Medicine | Exigence Medical of Jamestown Pllc | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Nicolas K Grundmann | Emergency Medicine | Exigence Medical of Jamestown Pllc | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Jillian Smith | Emergency Medicine | Exigence Medical of Jamestown Pllc | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Ashley Christine Balling | Nurse Practitioner | Exigence Medical of Jamestown Pllc | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Shaun Mc Brown | Emergency Medicine | Exigence Medical of Jamestown Pllc | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Ryan George Knopper | Emergency Medicine | Exigence Medical of Jamestown Pllc | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Christopher Reed Cammarata | Emergency Medicine | Exigence Medical of Jamestown Pllc | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Thomas Michael Simonian | Emergency Medicine | Exigence Medical of Jamestown Pllc | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Miguel A Roman-diaz | Family Medicine | Exigence Medical of Jamestown Pllc | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Jessica L Cappa | Nurse Practitioner | Exigence Medical of Jamestown Pllc | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Street Address |
207 FOOTE AVE |
| City | JAMESTOWN |
| State | NY |
| Zip | 14701-7077 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christian B Dolensek | Obstetrics/gynecology | Upmc Chautauqua At Wca | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Ashok B Movva | Internal Medicine | Upmc Chautauqua At Wca | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Corey G Daniels | Diagnostic Radiology | Jamestown Radiologists, P.C. | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Albert Eric Blair | Emergency Medicine | Exigence Medical of Jamestown Pllc | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Nicolas K Grundmann | Emergency Medicine | Exigence Medical of Jamestown Pllc | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Jill E Minger | Obstetrics/gynecology | Upmc Chautauqua At Wca | 207 Foote Ave, Jamestown, NY 14701-7077 |
| William A Swagler Iii | Internal Medicine | Upmc Chautauqua At Wca | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Jillian Smith | Emergency Medicine | Exigence Medical of Jamestown Pllc | 207 Foote Ave, Jamestown, NY 14701-7077 |
| James Michael Glenn | Orthopedic Surgery | Upmc Chautauqua At Wca | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Amit Bhowmik | Internal Medicine | Upmc Chautauqua At Wca | 207 Foote Ave, Jamestown, NY 14701-7077 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kara I Gibbs | Optometry | 779 Fairmont Ave, Jamestown, NY 14701 | |
| Albert J Persia | Family Medicine | Family Health Medical Services Pllc | 715 Falconer St, Jamestown, NY 14701-1935 |
| Carol Wright | Clinical Social Worker | County of Chautauqua - A Mun Corp | 139 Buffalo St, Jamestown, NY 14701-2149 |
| Jennifer Wolfe | Clinical Social Worker | County of Chautauqua - A Mun Corp | 139 Buffalo St, Jamestown, NY 14701-2149 |
| Kristin Saunders | Clinical Social Worker | County of Chautauqua - A Mun Corp | 139 Buffalo St, Jamestown, NY 14701-2149 |
| Karen Mary Dillon | Clinical Social Worker | County of Chautauqua - A Mun Corp | 139 Buffalo St, Jamestown, NY 14701-2149 |
| Vivien L Redeye | Family Medicine | Family Health Medical Services Pllc | 42 Dunham Ave, Jamestown, NY 14701-2514 |
| Katherine Meleen | Nurse Practitioner | Family Health Medical Services Pllc | 42 Dunham Ave, Jamestown, NY 14701-2514 |
| Elizabeth Gattman | Nurse Practitioner | Family Health Medical Services Pllc | 42 Dunham Ave, Jamestown, NY 14701-2514 |
| Kristin Sue Anderson-taylor | Physician Assistant | Family Health Medical Services Pllc | 42 Dunham Ave, Jamestown, NY 14701-2514 |
| Find all physicians in zip 14701 | |||
| City | JAMESTOWN |
| Zip Code | 14701 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | JAMESTOWN + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Derek B Kennedy.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.