| Kinnari Kennedy, | |
|
19415 Deerfield Avenue, Suite 112, Leesburg, VA 20176-8470 | |
| (703) 724-1195 | |
| (703) 724-4495 |
| Full Name | Kinnari Kennedy |
|---|---|
| Gender | Female |
| Speciality | Urology |
| Experience | 9 Years |
| Location | 19415 Deerfield Avenue, Suite 112, Leesburg, Virginia |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952763435 | NPI | - | NPPES |
| 30016381720001 | Medicaid | VA | |
| 1952763435 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | MT210270 (Pennsylvania) | Secondary |
| 208800000X | Urology | 0101271958 (Virginia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Inova Loudoun Hospital | Leesburg, VA | Hospital |
| Reston Hospital Center | Reston, VA | Hospital |
| Stonesprings Hospital Center | Dulles, VA | Hospital |
| Virginia Hospital Center | Arlington, VA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Loudoun Medical Group, Pc | 0042119661 | 298 |
| Loudoun Medical Group, Pc | 0042119661 | 298 |
| Entity Name | Loudoun Medical Group, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407908817 PECOS PAC ID: 0042119661 Enrollment ID: O20040102000616 |
| Mailing Address | Practice Location Address |
|---|---|
| Kinnari Kennedy, 224-d Cornwall Street, Nw, Suite 403, Leesburg, VA 20176-2704 Ph: (703) 737-6010 | Kinnari Kennedy, 19415 Deerfield Avenue, Suite 112, Leesburg, VA 20176-8470 Ph: (703) 724-1195 |
Dr. Kyle Matthew Lester, D.O. Urology Medicare: Accepting Medicare Assignments Practice Location: 19415 Deerfield Avenue, Suite 112, Leesburg, VA 20176 Phone: 703-724-1195 | |
Christine Ngoc Bich Tran, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 19415 Deerfield Avenue, Suite 112, Leesburg, VA 20176 Phone: 703-724-1195 Fax: 703-724-4495 | |
Chuck G Pruna, D.O. Urology Medicare: Accepting Medicare Assignments Practice Location: 19415 Deerfield Avenue, Suite 112, Leesburg, VA 20176 Phone: 703-724-1195 Fax: 703-724-4495 | |
Amanda Elizabeth Smart, Urology Medicare: Accepting Medicare Assignments Practice Location: 19415 Deerfield Avenue, Suite 112, Leesburg, VA 20176 Phone: 703-724-1195 Fax: 703-724-4495 | |
Gregory S Schenk, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 19415 Deerfield Avenue, Suite 112, Leesburg, VA 20176 Phone: 703-724-1195 Fax: 703-724-4495 | |
Kevin Paul O'connor, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 19415 Deerfield Ave Ste 112, Leesburg, VA 20176 Phone: 703-724-1195 Fax: 703-724-4495 | |
Dr. Walter M O'brien, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 19415 Deerfield Avenue, Suite 112, Leesburg, VA 20176 Phone: 703-724-1195 Fax: 703-724-4495 |