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DR. KEVIN RAYMOND GENDREAU M.D. NPI 1023422607


NPI Information

NPI: 1023422607
Provider Name: DR. KEVIN RAYMOND GENDREAU, M.D.
Classification: Family Medicine - 207QB0002X
Entity Type: Individual

Specialization: Obesity Medicine

PECOS Registration: Yes

Address:
110 LIBERTY ST
BROCKTON, MA
ZIP 02301
Phone: (508) 894-0400
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DR. Kevin Raymond Gendreau, M.D. is an obesity medicine family medicine in Brockton, MA with 10 years of experience. The provider is a family medicine physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilizes a comprehensive approach, and may include additional resources such as dietitians, exercise physiologists, mental health professionals and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre- peri- and post-surgical care of bariatric surgery patients, promotes the prevention of obesity, and advocates for those who suffer from obesity. DR. Kevin Raymond Gendreau, M.D. NPI is 1023422607. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2014

The provider's business location address is:

110 LIBERTY ST
BROCKTON, MA
ZIP 02301-674
Phone: (508) 894-0400
Fax: (508) 565-0097

The NPI 1023422607 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Vaccine for influenza for injection into muscle (HCPCS:90662)

The enumeration date for this NPI number is 6/11/2014 and was last updated on 3/10/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineMD17833RHODE ISLANDNo
2207Q00000XFamily Medicine270162MASSACHUSETTSNo
3207QB0002XFamily MedicineObesity Medicine270162MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1110118525AMEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.