Brian Kennedy, PA-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

8831 Issued in AZ

Practice address

2721 S San Tan Village Pkwy Ste 104
Gilbert, AZ 85295-0713

Phone

(480) 500-9307

NPI assigned

Aug 24, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Primary Care Walk-in Medical ClinicGroup PAC ID 5496975153, 13 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.05 of 100Reported as group

Quality

100

Improvement activities

40

Cost

66.83

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Primary Care Walk-in Medical Clinic

  • Family Medicine Physician
  • Fountain Hills, AZ
  • NPI 1790196806
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1566604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1952958837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 S SAN TAN VILLAGE PKWY STE 104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852950713",
            "telephone_number": "480-500-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 S SAN TAN VILLAGE PKWY STE 104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852950713",
            "telephone_number": "480-500-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "BRIAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-24",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "8831",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul John Kelly, DDS, MS
• Kaila Kelson
• Tara Ellan Kemnitz, LMT
• Carly Lin Kemp, FNP-BC
• Maria S Kenneally, APNP, BC
• Jacqueline Kennedy
• Julie Allen Kennedy, PAC
• Keith D Kennedy, DDS
• Taylor Kennedy, RD
• Jaclyn Kenney

• Family Medicine Physician in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.