Individual provider Active NPI

Kenadee Burgoyne

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1871387019
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9120665 Issued in FL
Practice address
7331 College Pkwy Ste 300
Fort Myers, FL 33907-5524
Phone
(239) 337-2003
Fax
(239) 337-3168
NPI assigned
Apr 4, 2025
Last updated
Jan 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9120665 FL Primary

Addresses

Primary practice location

7331 College Pkwy Ste 300
Fort Myers, FL 33907-5524

Mailing address

7331 College Pkwy Ste 300
Fort Myers, FL 33907-5524
Phone (239) 337-2003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20251019000004 FL Practitioner - Physician Assistant 0941798391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joint Implant Surgeons of Florida PAGroup PAC ID 7911909510, 25 clinicians

Practice addresses (Care Compare)

7331 College Pkwy
Fort Myers, FL 33907-5524
Phone (239) 337-2003

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Joint Implant Surgeons of Florida PA CurrentSince Sep 8, 2025 Accepting new patients
Joint Implant Surgeons of Florida PA CurrentSince Sep 8, 2025 Accepting new patients

Locations

7331 College Pkwy
Ste 300
Fort Myers, FL 33907
Phone (239) 337-2003

Organizations & group practices 2

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": "1743724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1871387019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7331 COLLEGE PKWY STE 300",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075524",
            "telephone_number": "239-337-2003",
            "fax_number": "239-337-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7331 COLLEGE PKWY STE 300",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075524",
            "telephone_number": "239-337-2003",
            "fax_number": "239-337-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOYNE",
        "first_name": "KENADEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-04",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9120665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.