KENNEDY BERGREN PA-C
NPI 1063361103
Physician Assistant in Coon Rapids, MN
About Kennedy Bergren Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENNEDY BERGREN PA-C (NPI 1063361103) is an individual physician assistant in Coon Rapids, Minnesota, licensed in Minnesota (15701) and active in the NPI registry since January 2026. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kennedy Bergren Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55433 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
COON RAPIDS, MN 55433
COON RAPIDS, MN 55433
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kennedy Bergren's NPI number?
The NPI number for Kennedy Bergren is 1063361103. It was assigned to this individual provider in the NPPES registry on January 22, 2026.
Where is Kennedy Bergren located?
Kennedy Bergren practices at 9055 Springbrook Dr NW, Coon Rapids, MN 55433. The listed phone number is (763) 780-9155.
What is Kennedy Bergren's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Kennedy Bergren enrolled in Medicare?
Yes. Kennedy Bergren is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Kennedy Bergren was last updated on May 5, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.
