Provider Demographics
NPI:1770679730
Name:KENEALY, JAMES FX (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FX
Last Name:KENEALY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2038
Mailing Address - Country:US
Mailing Address - Phone:508-368-3103
Mailing Address - Fax:508-368-3104
Practice Address - Street 1:123 SUMMER ST STE 300
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1216
Practice Address - Country:US
Practice Address - Phone:508-368-3103
Practice Address - Fax:508-368-3104
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA74266174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA040004967OtherTRAVELERS MEDICARE
MA54857OtherFALLON DIRECT/SELECT
MA61683OtherUSHC
MA074266OtherTUFTS
MA1000006OtherUNITED HEALTHCARE
MA19143OtherHARVARD PILGRIM MWMC IPA
MA19551OtherHARVARD PILGRIM MILF IPA
MA3087514Medicaid
MA0017055OtherNEIGHBORHOOD HEALTH
MA23504OtherCHILDRENS MEDICAL SEC
MAJ11142OtherBLUE CROSS BLUE SHEILD
MA19143OtherHARVARD PILGRIM MWMC IPA
MA19551OtherHARVARD PILGRIM MILF IPA