KELLY LYNN KENNEDY (NP) – Family Nurse Practitioner, NPI 1003248204

KELLY LYNN KENNEDY (NP) is a healthcare provider. based in Brookline, Massachusetts. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. RN2269814 (MA). The NPI Number for KELLY LYNN KENNEDY (NP) is 1003248204

Main info

Female
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
KELLY LYNN KENNEDY (NP)
NPI
1003248204
Phone
(518) 929-9218
Address
199 WINTHROP RD
Enumeration Date
30 July 2013
Last Update Date
28 October 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6174211000
Graduation Year
2013 (13 years ago)
PAC ID
2961630306
Group Practice PAC ID
4789588641
Professional Enrollment ID
I20140110001167
Address ID
MA022153904BO133XXAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

8,971 NURSE PRACTITIONER in MA

Provider Addresses for KELLY LYNN KENNEDY (NP)

  • 199 WINTHROP RD

    APT 33

    BROOKLINE, MA 024454485

    Phone: (518) 929-9218

    Type: Mailing

  • 137 W CENTRAL ST

    NATICK, MA 017604310

    Phone: (508) 655-2109

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-01-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140110001167INurse PractitionerMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes8377$0
99203New patient office or other outpatient visit, 30-44 minutes2222$0
99212Established patient office or other outpatient visit, 10-19 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 02445)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789588641View full group profile
NameSpecialtyState
-MA
Family PracticeMA
D E R M A T O L O G YMA
Emergency MedicineMA
Internal Medicine, Cardiovascular Disease (Cardiology)MA
-MA
O B S T E T R I C S/ G Y N E C O L O G YMA
-MA
Internal MedicineMA
O T O L A R Y N G O L O G YMA

Reviews

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Frequently asked questions

Can I cross-check KELLY LYNN KENNEDY (NP) using NPI 1003248204?
NPI 1003248204 belongs to KELLY LYNN KENNEDY (NP); compare other details if you need extra assurance.
Active or inactive — what applies to KELLY LYNN KENNEDY (NP)?
You should see KELLY LYNN KENNEDY (NP) as active in CMS-hosted NPPES data.
What kind of doctor is KELLY LYNN KENNEDY (NP)?
KELLY LYNN KENNEDY (NP) is associated with Family Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
Is KELLY LYNN KENNEDY (NP) located near Brookline?
KELLY LYNN KENNEDY (NP) currently maps to Brookline, Massachusetts in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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