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SAMUEL KENNEDY MD
NPI 1538798285
Student in an Organized Health Care Education/Training Program in Gainesville, FL

Active since April 05, 2020PECOS Enrolled
1600 SW ARCHER RD STE 4102, GAINESVILLE, FL 32610(352) 265-0239 Get Directions Write a Review

NPPES record last updated: April 5, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Samuel Kennedy Md NPPES

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

SAMUEL KENNEDY MD (NPI 1538798285) is an individual student in an organized health care education/training program in Gainesville, Florida and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS and is a graduate of Ohio State University College Of Medicine (2020).

NPPES Registry Identity

NPI1538798285
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSAMUEL KENNEDYCredential: MD
Location Address1600 SW ARCHER RD STE 4102Gainesville, FL 32610-3003
Mailing AddressPo Box 100277Gainesville, FL 32610-0265
Phone(352) 265-0239
Sole ProprietorNo
Medical School CMSOhio State University College Of MedicineGraduated 2020
Enumeration DateApril 5, 2020
NPPES CertifiedApril 5, 2020
✔ NPI 1538798285 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1600 SW ARCHER RD STE 4102, Gainesville, FL 32610
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Kennedy Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4688084148
PECOS Enrollment IDI20260520003671
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.

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.

MR. ADNAN BASHIR BHAT MD
Internal Medicine
1600 SW ARCHER RD STE 4102
GAINESVILLE, FL 32610
Alachua County (352) 265-0239
DR. EVAN LOUIS BARRIOS MD
Student in an Organized Health Care Education/Training Program
1600 SW ARCHER RD STE 4102
GAINESVILLE, FL 32610
Alachua County (352) 265-0239
DR. JUSTIN EDWARD LEWIS MD
Internal Medicine
1600 SW ARCHER RD STE 4102
GAINESVILLE, FL 32610
Alachua County (352) 265-0239
MICHAEL RYAN BLOTNER
Student in an Organized Health Care Education/Training Program
1600 SW ARCHER RD STE 4102
GAINESVILLE, FL 32610
Alachua County (352) 265-0239
STEVEN MATTHEW BRADY DO
Student in an Organized Health Care Education/Training Program
1600 SW ARCHER RD STE 4102
GAINESVILLE, FL 32610
Alachua County (352) 265-0239
ALEXANDRA DE LEO
Radiology (Radiation Oncology)
1600 SW ARCHER RD STE 4102
GAINESVILLE, FL 32610
Alachua County (352) 265-0239
HANNAH JACON PA-C
Physician Assistant
1600 SW ARCHER RD STE 4102
GAINESVILLE, FL 32610
Alachua County (352) 265-0239
DR. DANIEL AINE DO
Student in an Organized Health Care Education/Training Program
1600 SW ARCHER RD STE 4102
GAINESVILLE, FL 32610
Alachua County (352) 265-8017

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 Samuel Kennedy's NPI number?

The NPI number for Samuel Kennedy is 1538798285. It was assigned to this individual provider in the NPPES registry on April 5, 2020.

Where is Samuel Kennedy located?

Samuel Kennedy practices at 1600 SW Archer Rd Ste 4102, Gainesville, FL 32610. The listed phone number is (352) 265-0239.

What is Samuel Kennedy's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Samuel Kennedy enrolled in Medicare?

Yes. Samuel Kennedy is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Samuel Kennedy was last updated on April 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.