Michael Kenny, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9121142 Issued in FL

Practice address

8350 Riverwalk Park Blvd Ste 1
Fort Myers, FL 33919-8759

Phone

(239) 343-9696

Fax

(239) 343-4198

NPI assigned

May 11, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI, FL2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Macomb Hospital CorporationGroup PAC ID 7911808381, 349 clinicians

Lee Health System IncGroup PAC ID 9335672146, shared by 11 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkenny449961@direct.hfhs.org

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.

• Henry Ford Macomb Hospital Corporation

  • Family Medicine Physician
  • Clinton TWP, MI
  • NPI 1134265986
  Medicare reassignment Care Compare group
• Henry Ford Health System

  • Physician Assistant
  • Detroit, MI
  • NPI 1811073901
  Medicare reassignment NPD
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  NPD
• Henry Ford Macomb Hospital Corporation

  • Physician Assistant
  • Clinton TWP, MI
  • NPI 1124421888
  NPD
• Henry Ford Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
  • NPI 1851410005
  NPD

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

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1902842735
  Care Compare affiliation

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1467988451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-9696",
            "fax_number": "239-343-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8350 RIVERWALK PARK BLVD STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339198759",
            "telephone_number": "239-343-9696",
            "fax_number": "239-343-4198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12150 30 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Washington Township",
            "state": "MI",
            "postal_code": "480952035",
            "country_code": "US",
            "telephone_number": "586-336-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNY",
        "first_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008191",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9121142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130774200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkenny449961@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "12150 30 Mile Rd",
            "city": "Washington Township",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480952035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Johnathan Kennedy, MD
• Erica A Kennerly
• Kenneth a. Berdick, M.D., P.a.
• Kenneth J. Galang, M.D., P.a.
• Elizabeth Ann Kenney, DPT
• Laura Lynn Kent-White, APRN
• Stacy Kentrus
• Richard Coulbourn Keown, MD
• Irene M Kepler, LCSW
• Judith Kerfoot, PT

• Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.