TIMOTHY J KENNEDY MD
NPI 1417985631
Urology in Green Bay, WI

Q: What is Timothy Kennedy's NPI number?

The NPI number for Timothy Kennedy is 1417985631. It was assigned to this individual provider in the NPPES registry on June 28, 2006.

Q: What is Timothy Kennedy's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Timothy Kennedy was last updated on June 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 28, 2006PECOS Enrolled

2845 GREENBRIER RD STE 240, GREEN BAY, WI 54311(920) 288-8280(920) 288-8285 Get Directions Write a Review

NPPES record last updated: June 1, 2021. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Timothy J Kennedy Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIMOTHY J KENNEDY MD (NPI 1417985631) is an individual urology provider in Green Bay, Wisconsin, licensed in Wisconsin (29987) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417985631

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameTIMOTHY J KENNEDYCredential: MD

Location Address2845 GREENBRIER RD STE 240Green Bay, WI 54311-6519

Mailing Address2034 Shady LnGreen Bay, WI 54313-9313 · (920) 621-1785

Phone(920) 288-8280

Fax(920) 288-8285

Sole ProprietorNo

Enumeration DateJune 28, 2006

Last NPPES UpdateJune 1, 2021

NPPES CertifiedJune 1, 2021

✔ NPI 1417985631 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in WI · 29987

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

2845 GREENBRIER RD STE 240, Green Bay, WI 54311

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Other Identifiers 5

Other3402100592MI · Bcbs

Medicaid31501900WI

Medicaid104386126MI

Medicaid104386153MI

Other340015995WI · Railroad

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Timothy J Kennedy Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54311 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

4 suppliers20 claims6,420 services$1.64 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEATHER M STEFANIAK MD

Urology