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GANNON DANIEL KENNEDY M.D.
NPI 1083933535
Orthopaedic Surgery - Sports Medicine in Redwood City, CA

Active since May 24, 2010PECOS EnrolledAccepts Medicare Assignment
500 ARGUELLO ST STE 100, REDWOOD CITY, CA 94063(650) 995-1285(650) 995-1208 Get Directions Write a Review

NPPES record last updated: January 4, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 4, 2022, Mar 17, 2018, Jun 12, 2017 (3 updates tracked since 2017).

About Gannon Daniel Kennedy M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GANNON DANIEL KENNEDY M.D. (NPI 1083933535) is an individual sports medicine provider in Redwood City, California, licensed in California (A117899) and active in the NPI registry since May 2010. He is enrolled in Medicare PECOS, maintains a secondary practice location in Sacramento, and is a graduate of Miami Medical College (2010).

NPPES Registry Identity

NPI1083933535
Entity TypeIndividualMale
Primary Taxonomy207XX0005X
Provider Legal NameGANNON DANIEL KENNEDYCredential: M.D.
Location Address500 ARGUELLO ST STE 100Redwood City, CA 94063-1567
Mailing Address500 Arguello St Ste 100Redwood City, CA 94063-1567 · (650) 995-1285 · Fax (650) 995-1208
Phone(650) 995-1285
Fax(650) 995-1208
Sole ProprietorNo
Medical School CMSMiami Medical CollegeGraduated 2010
Enumeration DateMay 24, 2010
Last NPPES UpdateJanuary 4, 20223 updates tracked since enumeration
✔ NPI 1083933535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207XX0005X
License✔ Licensed in CA · A117899
Definition
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License A117899 (CA)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
500 ARGUELLO ST STE 100, Redwood City, CA 94063
Open in Google Maps ↗

Secondary Practice Location 1

Location 14860 Y St, Suite 3800Sacramento, CA 95817-2307 · Phone (916) 734-2700 · Fax (916) 703-5074

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gannon Daniel Kennedy M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6406026442
PECOS Enrollment IDI20110830000198
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Gannon Kennedy reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
0.6 mi
Internal Medicine
1190 VETERANS BLVD
Redwood City, CA 94063
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1639252604 (650) 299-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAH ORTHOPAEDIC ASSOCIATES
Orthopaedic Surgery
500 ARGUELLO ST STE 100
REDWOOD CITY, CA 94063
San Mateo County (510) 818-7210

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 Gannon Kennedy's NPI number?

The NPI number for Gannon Kennedy is 1083933535. It was assigned to this individual provider in the NPPES registry on May 24, 2010.

Where is Gannon Kennedy located?

Gannon Kennedy practices at 500 Arguello St Ste 100, Redwood City, CA 94063. The listed phone number is (650) 995-1285.

What is Gannon Kennedy's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Gannon Kennedy enrolled in Medicare?

Yes. Gannon Kennedy is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Gannon Kennedy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gannon Kennedy reassigns Medicare benefits to Permanente Medical Group Inc (Redwood City, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gannon Kennedy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Gannon Kennedy was last updated on January 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.