DR. KATHARINE KENNEDY TREADWAY (MD) – Internal Medicine Physician, NPI 1417944141

DR. KATHARINE KENNEDY TREADWAY (MD) is a healthcare provider. based in Charlestown, Massachusetts. specializing in Internal Medicine Physician. They hold the professional credentials MD. They hold a License No. 47706 (MA). The NPI Number for DR. KATHARINE KENNEDY TREADWAY (MD) is 1417944141

Main info

Female
48 Years Of Experience
Accepts Medicare Assignment
Name
DR. KATHARINE KENNEDY TREADWAY (MD)
NPI
1417944141
Phone
(617) 724-0287
Address
PO BOX 9142
Enumeration Date
27 September 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
PERELMAN SCHOOL OF MED AT THE UNIVERSITY OF PENNSYLVANIA
Secondary Phone
6177262000
Graduation Year
1978 (48 years ago)
PAC ID
8224012752
Group Practice PAC ID
6507803806
Professional Enrollment ID
I20040614001225
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. KATHARINE KENNEDY TREADWAY (MD)

  • Charlestown Post Office (mobile), Pattern Close, St Austell Bay, Charlestown, Cornwall, England, PL25 3FQ, United Kingdom

    MASS GENERAL PHYSICIAN ORGANIZATION

    CHARLESTOWN, MA 021299142

    Phone: (617) 724-0287

    Fax: (617) 726-2894

    Type: Mailing

  • Wang Ambulatory Care Center, 15, Parkman Street, West End, Boston, Suffolk County, Massachusetts, 02114, United States

    WAC 615 INTERNAL MEDICINE ASSOCIATES TEAM 2

    BOSTON, MA 021143117

    Phone: (617) 726-2674

    Fax: (617) 724-0656

    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: 2004-06-14

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
I20040614001225IInternal MedicineMATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02129)

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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: 6507803806View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YMA
Internal MedicineMA
-MA
-MA
Anesthesiology, Pain ManagementMA
-MA
Clinical PsychologistMA
Internal MedicineMA
Internal MedicineMA
-MA

Reviews

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Frequently asked questions

How do I look up DR. KATHARINE KENNEDY TREADWAY (MD) by NPI?
Use NPI 1417944141 when you need to reference DR. KATHARINE KENNEDY TREADWAY (MD) in forms, claims, or directories.
Is DR. KATHARINE KENNEDY TREADWAY (MD)'s NPI currently valid?
The extract we use shows DR. KATHARINE KENNEDY TREADWAY (MD) as active.
Can you summarize DR. KATHARINE KENNEDY TREADWAY (MD)'s specialty in plain language?
Clinically, the directory lists DR. KATHARINE KENNEDY TREADWAY (MD) with Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Where does public data place DR. KATHARINE KENNEDY TREADWAY (MD)?
The snapshot lists Charlestown, Massachusetts for DR. KATHARINE KENNEDY TREADWAY (MD); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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