Samantha Kennedy, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

5151 Park Ave
Masters of Physician Assistant Studies Program
Fairfield, CT 06825

Phone

(203) 989-9237

NPI assigned

Aug 29, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Children'S Hospital

  • Children's Hospital
  • Washington, DC
  • NPI 1912939703
  Medicare reassignment NPD (past)
• Children'S Hospital

  • Community/Retail Pharmacy
  • Silver Spring, MD
  • NPI 1326878349
  NPD
• Children'S Hospital

  • Pediatrics Physician
  • Washington, DC
  • NPI 1780800128
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708732800000",
    "number": "1003691072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 PARK AVENUE",
            "address_2": "MASTERS OF PHYSICIAN ASSISTANT STUDIES PROGRAM",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "06825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 PARK AVE",
            "address_2": "MASTERS OF PHYSICIAN ASSISTANT STUDIES PROGRAM",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "06825",
            "telephone_number": "203-989-9237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "SAMANTHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2024-02-24",
        "certification_date": "2024-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice Z Kelly, LCSW
• Anyse Kelly
• Katherine Kendall
• Christina M Kennedy
• Elizabeth J Kennedy, MS, CCC-SLP
• Matthew C. Kenney, D.C.
• Barry Kerner, MD
• Tara Kerner, DO
• Vincent E Kerr, M.D.
• Kevin M. Barajas DDS, P.C.

• Physician Assistant in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.