KENEIL A WILLIAMS – Primary Care Nurse Practitioner, NPI 1407551286

KENEIL A WILLIAMS is a healthcare provider. based in Paterson, New Jersey. specializing in NURSE PRACTITIONER. They hold a License No. AG09220094 (NJ). The NPI Number for KENEIL A WILLIAMS is 1407551286

Main info

Male
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
KENEIL A WILLIAMS
NPI
1407551286
Phone
(973) 413-5590
Address
268 MCBRIDE AVE
Enumeration Date
3 April 2023
Last Update Date
3 April 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9735895545
Graduation Year
2022 (4 years ago)
PAC ID
3779931571
Group Practice PAC ID
2668447939
Professional Enrollment ID
I20231204002047
Address ID
NJ071051570NE275XXSTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

7,574 NURSE PRACTITIONER in NJ

Provider Addresses for KENEIL A WILLIAMS

  • 268 MCBRIDE AVE

    BUILDING 2 APT 3

    PATERSON, NJ 07501

    Phone: (973) 413-5590

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $27.

Total Amount is formed as General ($27) + Research ($0) + Ownership ($0) = $27.

Last reported payment date: 2024-07-27 • Largest payer in this snapshot: ABBVIE INC. ($27).

Total Amount

$27

General + Research + Ownership

Payments

2

Total payment records

General Amount

$27

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-27

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$27
View all Open Payments →|Open Payments Risk Radar →

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: 2023-12-04

PECOS data refreshed: 2026-06-15

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
I20231204002047INurse PractitionerNJTBD

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 07501)

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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: 2668447939View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YNJ
Nurse PractitionerNJ
G A S T R O E N T E R O L O G YNJ

Reviews

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Frequently asked questions

How is KENEIL A WILLIAMS identified in CMS data?
CMS-hosted NPPES data lists KENEIL A WILLIAMS with NPI 1407551286.
Is KENEIL A WILLIAMS listed as active for patients and plans?
The listing shows KENEIL A WILLIAMS as active in the NPI system.
What taxonomy line describes KENEIL A WILLIAMS?
For research purposes, treat KENEIL A WILLIAMS as Primary Care Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What area does KENEIL A WILLIAMS serve?
KENEIL A WILLIAMS's listing highlights Paterson, New Jersey; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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