Tracy Kennelley, P.A-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA167858 Issued in OR

Practice address

2200 NE Neff Rd Ste 200
Bend, OR 97701-4281

Phone

(541) 382-3344

Fax

(541) 382-1681

NPI assigned

Oct 17, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tkennelley99840@secure.stcharleshealthcare.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.

• St. Charles Health System, Inc.

  • Family Medicine Physician
  • Bend, OR
  • NPI 1023331303
  Medicare reassignment Care Compare group NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Roseburg, OR
  • NPI 1780647719
  Medicare reassignment NPD
• St. Charles Health System, Inc.

  • Critical Access Hospital
  • Prineville, OR
  • NPI 1710160445
  Medicare reassignment NPD
• St. Charles Health System, Inc.

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Medicare reassignment NPD (past)
• Icco, LLC

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1407004757
  Medicare reassignment
• St. Charles Health System, Inc.

  • Critical Access Hospital
  • Madras, OR
  • NPI 1356389894
  Medicare reassignment
• Icco, LLC

  • Physical Therapist
  • Eugene, OR
  • NPI 1528385754
  NPD
• St. Charles Health System, Inc.

  • Rehabilitation Hospital Unit
  • Bend, OR
  • NPI 1154343150
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• St. Charles Health System, Inc.

  • Rural Health Clinic/Center
  • Prineville, OR
  • NPI 1407178528
  NPD (past)
• St. Charles Health System, Inc.

  • Clinical Social Worker
  • Bend, OR
  • NPI 1780698696
  NPD (past)

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

• Cascade Healthcare Community Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Bend, OR
  • NPI 1164675963

  Hospital

  Care Compare affiliation
• St. Charles Health System, Inc.

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Care Compare affiliation

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

{
    "created_epoch": "1381968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1639507288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6095",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977086095",
            "telephone_number": "541-706-5922",
            "fax_number": "541-706-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NE NEFF RD STE 200",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014281",
            "telephone_number": "541-382-3344",
            "fax_number": "541-382-1681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 N Indian Canyon Dr",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922624872",
            "country_code": "US",
            "telephone_number": "760-323-6511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNELLEY",
        "first_name": "TRACY",
        "credential": "P.A-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-17",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51221",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA167858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkennelley99840@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2200 NE Neff Rd Ste 200",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977014281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Fredrick Frank Kennaday, RN
• Lisa Marie Kennedy-Leary, PT
• Kenya Marie Kennedy, LMT
• Kindra Michelle Kennedy, CPM, LDM, IBCLC
• Larry Kennedy, CRM
• Kenneth M. Shirtcliff D.M.D. P.C.
• Edward Joseph Kent III, MD
• Marina Ashley Kent, RN
• Sarah Loney Kent, PA-C
• Joseph Kentta

• Physician Assistant in Bend, OR
• Providers in Bend, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.