Individual provider Active NPI

Evan Paul Kennedy, PA-C

  • Physician Assistant
  • York, PA
National Provider Identifier
1164613592
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA002796 Issued in PA
Practice address
2960 E Market St
York, PA 17402-2414
Phone
(717) 751-2483
NPI assigned
Aug 9, 2007
Last updated
Feb 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA-053002 PA
Physician Assistant 363A00000X OA002796 PA Primary

Addresses

Primary practice location

2960 E Market St
York, PA 17402-2414

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 968-5700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address PAExchange@patientfirstclinics.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20070817000358 PA Practitioner - Physician Assistant 3678665809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

107 S Sporting Hill Rd
Mechanicsburg, PA 17050-3058
Phone (717) 943-1781

2960 E Market St
York, PA 17402-2414
Phone (717) 751-2483

5125 Jonestown Rd
Suite 105
Harrisburg, PA 17112-2987
Phone (717) 943-1566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
OA002796PAMDPhysician Assistant
MA-053002PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Pennsylvania Medical Group PLLC CurrentSince Aug 20, 2013 Accepting new patients
Patient First Pennsylvania Medical Group PLLC Current Accepting new patients
Patient First Pennsylvania Medical Group PLLC CurrentSince Aug 20, 2013 Accepting new patients

Locations

5125 Jonestown Rd
Ste 105
Harrisburg, PA 17112
Phone (717) 943-1566

713 Bethlehem Pike
Montgomeryvle, PA 18936
Phone (267) 695-3944

2960 E Market St
York, PA 17402
Phone (717) 751-2483

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

Interoperability endpoints

  • Direct secure messaging: paexchange@patientfirstclinics.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1164613592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 E MARKET ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022414",
            "telephone_number": "717-751-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "EVAN",
        "middle_name": "PAUL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA-053002",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA002796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2960 E Market St",
            "city": "York",
            "state": "PA",
            "country_code": "US",
            "postal_code": "174022414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.