Kenilworth Primary Care LLC
NPI 1164793014 · Primary Care Clinic/Center · Kenilworth, NJ
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kenilworth Primary Care LLC is a Primary Care Clinic/Center organization in Kenilworth, NJ (NPI 1164793014).
Provider details
- NPI number
- 1164793014
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Bhavani Jeereddy, Sole Member(908) 276-9595
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2012-01-24
- Last updated
- 2012-01-24
Frequently asked questions
- What is Kenilworth Primary Care LLC's NPI number?
- Kenilworth Primary Care LLC's National Provider Identifier (NPI) is 1164793014, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kenilworth Primary Care LLC?
- Kenilworth Primary Care LLC is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Kenilworth Primary Care LLC located?
- Kenilworth Primary Care LLC's practice location on file with NPPES is 66 S 21st St, Kenilworth, NJ 07033-1626.
- What is Kenilworth Primary Care LLC's phone number?
- The practice phone number listed in the NPPES registry for Kenilworth Primary Care LLC is (908) 276-9595.
- Does Kenilworth Primary Care LLC accept Medicare?
- Kenilworth Primary Care LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Kenilworth Primary Care LLC?
- The authorized official listed on Kenilworth Primary Care LLC's NPPES record is Bhavani Jeereddy, Sole Member. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kenilworth Primary Care LLC's NPI active?
- Yes — Kenilworth Primary Care LLC's NPI (1164793014) is active in the NPPES registry as of the last update on 2012-01-24.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.