Individual provider Active NPI

Bruce David Kennedy, M.D.

  • Anesthesiology Physician
  • Seguin, TX
National Provider Identifier
1386627461
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
K2049 Issued in TX
Practice address
1215 E Court St
Seguin, TX 78155-5129
Phone
(830) 379-5867
Fax
(830) 401-4035
NPI assigned
Nov 22, 2005
Last updated
Nov 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X K2049 TX Primary

Addresses

Primary practice location

1215 E Court St
Seguin, TX 78155-5129

Mailing address

1215 E Court St
Seguin, TX 78155-5129
Phone (830) 379-5867

Other identifiers 1

IdentifierTypeStateIssuer
1061608-02MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100816000028 TX Practitioner - Anesthesiology 5496889347 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Texas Tech University Health Science Center School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates of Seguin PLLCGroup PAC ID 4284620592, 24 clinicians

Practice addresses (Care Compare)

1215 E Court St
Seguin, TX 78155-5129
Phone (830) 379-5867

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
U S Anesthesia Partners of Texas, PA Anesthesiology CurrentSince Sep 3, 2019 Accepting new patients
Anesthesia Associates of Seguin PLLC Anesthesiology CurrentSince Dec 1, 2021 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Anesthesiology CurrentSince Sep 3, 2019 Accepting new patients
Tejas Anesthesia PLLC Anesthesiology CurrentSince May 15, 2017 Accepting new patients
Tejas Anesthesia PLLC Anesthesiology CurrentSince May 15, 2017 Accepting new patients
Alamo Anesthesia, PLLC Anesthesiology Past Accepting new patients

Locations

499 10th St
Floresville, TX 78114
Phone (830) 216-7096

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

2240 Gulf Fwy S
League City, TX 77573
Phone (832) 505-1000

4242 Medical Dr
Ste 1260
San Antonio, TX 78229
Phone (210) 477-9551

4242 Medical Dr
Ste 3100
San Antonio, TX 78229
Phone (210) 477-9555

1215 E Court St
Seguin, TX 78155
Phone (830) 379-2411

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1386627461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 E COURT ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555129",
            "telephone_number": "830-379-5867",
            "fax_number": "830-401-4035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E COURT ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555129",
            "telephone_number": "830-379-5867",
            "fax_number": "830-401-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "BRUCE",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "K2049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1061608-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seguin, TX

Sources for this page

Verify at the official NPI Registry.