Michael D Kennedy, PA C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

C0002738 Issued in MD

Practice address

86 Thomas Johnson CT
Frederick, MD 21702-4348

Phone

(301) 694-8311

NPI assigned

Sep 27, 2005

Last updated

Jun 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.kennedy.1@3812.direct.athenahealth.com

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.

• Centers for Advanced Orthopaedics, LLC

  • Orthopaedic Surgery Physician
  • Olney, MD
  • NPI 1487093167
  Medicare reassignment
• Centers for Advanced Orthopaedics, LLC

  • Orthopaedic Surgery Physician
  • Gainesville, VA
  • NPI 1063393833
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1972599678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 THOMAS JOHNSON CT",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024348",
            "telephone_number": "301-694-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 THOMAS JOHNSON CT",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024348",
            "telephone_number": "301-694-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0002738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.kennedy.1@3812.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "86 Thomas Johnson Ct",
            "city": "Frederick",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217024348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kema Health Services
• Rachel Kenawell
• Josyane Kengni, NP
• Hannah Kennedy, DPT
• Kaitlin Valeri Kennedy, LCSW-C
• Rachel Kennedy
• Kenneth J. Benjamin, DPM, PA
• Monica Kenney-Sherlock
• Amber Kent
• Daniel H Kern, D.M.D.

• Surgical Physician Assistant in Frederick, MD
• Providers in Frederick, MD by specialty
• Surgical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.