Individual provider Active NPI

Jennifer K Kennedy, MD

  • Gastroenterology Physician
  • Seattle, WA
National Provider Identifier
1821472317
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD61291620 Issued in WA
Practice address
1221 Madison St Ste 1220
Seattle, WA 98104-1356
Phone
(206) 215-4250
Fax
(206) 215-4252
NPI assigned
Jul 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD61291620 WA Primary

Addresses

Primary practice location

1221 Madison St Ste 1220
Seattle, WA 98104-1356

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other practice location 1

5350 Tallman Ave NW Ste 520
Seattle, WA 98107-5910
Phone (206) 215-4250

Other identifiers 1

IdentifierTypeStateIssuer
2218952MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20190221002404 CA Practitioner - Internal Medicine 3072813815 Reassigns benefits to 1 organization
I20220901000838 WA Practitioner - Gastroenterology 3072813815 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Rochester School of Medicine and Dentistry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacmed ClinicsGroup PAC ID 2466350657, 211 clinicians
Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Practice addresses (Care Compare)

1101 Madison St
Suite 301
Seattle, WA 98104-3599
Phone (206) 505-1300

5350 Tallman Ave NW
Suite 520
Seattle, WA 98107-5910
Phone (206) 215-4250

Hospital & facility affiliations

  • Swedish Medical Center Hospital, Seattle, WA, CCN 500027
  • Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026
  • Swedish Issaquah Hospital, Issaquah, WA, CCN 500152
  • Swedish Medical Center / Cherry Hill Hospital, Seattle, WA, CCN 500025

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy54
Upper gastrointestinal (GI) endoscopy for acid reflux84

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Internal Medicine CurrentSince Sep 12, 2022 Accepting new patients
DCHS Medical Foundation Internal Medicine CurrentSince Nov 29, 2018 Accepting new patients
Pacmed Clinics CurrentSince Oct 5, 2022 Accepting new patients
Pacmed Clinics CurrentSince Oct 5, 2022 Accepting new patients
Pacmed Clinics Internal Medicine Current Accepting new patients
Verity Medical Foundation CurrentSince Nov 29, 2018 Accepting new patients
Morgan Hill Medical Associates Inc Internal Medicine Past Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

25455 Medical Center Dr
Ste 200
Murrieta, CA 92562
Phone (951) 894-7056

400 Race St
San Jose, CA 95126

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

220 15th Ave SE
Puyallup, WA 98372
Phone (253) 435-3400

5350 Tallman Ave NW
Ste 520
Seattle, WA 98107
Phone (206) 215-4250

1221 Madison St
Ste 1220
Seattle, WA 98104
Phone (206) 215-4250

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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": "1436832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1821472317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 MADISON ST STE 1220",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041356",
            "telephone_number": "206-215-4250",
            "fax_number": "206-215-4252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5350 Tallman Ave NW Ste 520",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981075910",
            "country_code": "US",
            "telephone_number": "206-215-4250",
            "fax_number": "206-215-4252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JENNIFER",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-14",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD61291620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2218952",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.