Individual provider Active NPI

Jeffrey S Kennedy, M.D.

  • Internal Medicine Physician
  • Everett, WA
National Provider Identifier
1063450369
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD61462276 Issued in WA
Practice address
3927 Rucker Ave
Everett, WA 98201-4833
Phone
(425) 339-5422
Fax
(425) 339-5444
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD61462276 WA Primary

Addresses

Primary practice location

3927 Rucker Ave
Everett, WA 98201-4833

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX, WA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20130213000001 NY Practitioner - Internal MedicinePractitioner - Infectious Disease 2466606850 Reassigns benefits to 2 organizations
I20231108002638 TX Practitioner - Internal Medicine 2466606850 Reassigns benefits to 1 organization
I20240202001437 WA Practitioner - Internal Medicine 2466606850 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ellis HospitalGroup PAC ID 5890607410, 250 clinicians
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians
The Polyclinic PLLCGroup PAC ID 2163328196, 364 clinicians

Practice addresses (Care Compare)

1101 Nott St
Schenecctady, NY 12308-2425
Phone (518) 243-4000

3927 Rucker Ave
Everett, WA 98201-4833
Phone (425) 259-0966

9709 3Rd Ave NE
Optum Northgate Plaza Urgent Care
Seattle, WA 98115-2077
Phone (206) 401-3191

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD61462276WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College CurrentSince Nov 28, 2012 Accepting new patients
The Polyclinic PLLC Internal Medicine CurrentSince Jan 17, 2024 Accepting new patients
The Polyclinic PLLC Internal Medicine Current Accepting new patients
Optum Care Washington PLLC CurrentSince Dec 4, 2023 Accepting new patients
Optum Care Washington PLLC Internal Medicine Current Accepting new patients
Albany Medical College Internal Medicine Current Accepting new patients
US Dept of HHS CurrentSince Sep 19, 2023 Accepting new patients
Albany Medical College Internal Medicine CurrentSince May 1, 2019 Accepting new patients
Optum Care Washington PLLC Internal Medicine CurrentSince Dec 4, 2023 Accepting new patients
U S Health Dept of Health & Human Services CurrentSince Sep 19, 2023 Accepting new patients
Ellis Hospital CurrentSince Aug 2, 2022 Accepting new patients
US Health Dept of Health & Human Services Current Accepting new patients
Albany Medical College Infectious Disease CurrentSince Nov 28, 2012 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients
Whitney M. Young Jr. Health Center, Inc. Past Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

47 New Scotland Ave
#136
Albany, NY 12208

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

25 Hackett Blvd
Albany, NY 12208
Phone (518) 262-1200

25 Hackett Blvd
Ste 1
Albany, NY 12208

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

3927 Rucker Ave
Everett, WA 98201
Phone (425) 339-5419

1145 Broadway
Seattle, WA 98122

9709 3rd Ave NE
Seattle, WA 98115
Phone (206) 525-5777

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

1812 S J St
Ste 102
Tacoma, WA 98405
Phone (253) 552-4900

Interoperability endpoints

  • Direct secure messaging: jkennedy82197@direct.tecmc.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1063450369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3927 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014833",
            "telephone_number": "425-339-5422",
            "fax_number": "425-339-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61462276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.