1. Home
  2. Directory
  3. New Jersey
  4. Montville
  5. Psychiatry Neurology
  6. NPI Profile

MARY C KANNANKERIL MD.,PA
NPI 1538406574
Psychiatry & Neurology - Psychiatry in Montville, NJ

Active since January 10, 2013
170 CHANGEBRIDGE RD, SUITE B 3-4, MONTVILLE, NJ 07045(973) 276-0041(973) 628-1935 Get Directions Write a Review

NPPES record last updated: November 20, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Mary C Kannankeril Md.,pa NPPES

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

MARY C KANNANKERIL MD.,PA (NPI 1538406574) is a healthcare organization registered as a psychiatry in Montville, New Jersey and active in the NPI registry since January 2013. The organization lists Mary C Kannankeril, Owner, as its authorized official.

NPPES Registry Identity

NPI1538406574
Entity TypeOrganization
Primary Taxonomy2084P0800X
Legal Business NameMARY C KANNANKERIL MD.,PA
Location Address170 CHANGEBRIDGE RD, SUITE B 3-4Montville, NJ 07045-9115
Mailing Address170 Changebridge Rd, Suite B 3-4Montville, NJ 07045-9115 · (973) 276-0041 · Fax (973) 628-1935
Phone(973) 276-0041
Fax(973) 628-1935
Organization SubpartNo
Authorized OfficialMary C KannankerilOwner · (973) 276-0041
Enumeration DateJanuary 10, 2013
Last NPPES UpdateNovember 20, 2023
NPPES CertifiedNovember 20, 2023
✔ NPI 1538406574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
170 CHANGEBRIDGE RD, Montville, NJ 07045
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary C Kannankeril Md.,pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mary C Kannankeril MD.,pa, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mary Kannankeril
Psychiatry
NPI 1629115126
170 CHANGEBRIDGE RD BUILDING B3-4
Montville, NJ 07045
(973) 276-0041
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary C Kannankeril Md.,pa's NPI number?

The NPI number for Mary C Kannankeril Md.,pa is 1538406574. It was assigned to this organization in the NPPES registry on January 10, 2013.

Where is Mary C Kannankeril Md.,pa located?

Mary C Kannankeril Md.,pa is located at 170 Changebridge Rd Suite B 3-4, Montville, NJ 07045. The listed phone number is (973) 276-0041.

What is Mary C Kannankeril Md.,pa's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Mary C Kannankeril Md.,pa enrolled in Medicare?

Yes. Mary C Kannankeril Md.,pa is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mary C Kannankeril Md.,pa?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Psychiatry) reassigns their Medicare billing to Mary C Kannankeril Md.,pa. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mary C Kannankeril Md.,pa was last updated on November 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.