PATRICK KENNEDY
NPI 1720646375
Nurse Practitioner - Acute Care in Warren, MI

Q: What is Patrick Kennedy's NPI number?

The NPI number for Patrick Kennedy is 1720646375. It was assigned to this individual provider in the NPPES registry on May 30, 2019.

Q: What is Patrick Kennedy's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Patrick Kennedy was last updated on July 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.

Active since May 30, 2019PECOS Enrolled

11800 E 12 MILE RD, WARREN, MI 48093(586) 573-5000 Get Directions Write a Review

NPPES record last updated: July 27, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 27, 2026, May 30, 2019 (2 updates tracked since 2019).

On this page

About Patrick Kennedy NPPES

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

PATRICK KENNEDY (NPI 1720646375) is an individual acute care provider in Warren, Michigan, licensed in Michigan (4704301492) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS, maintains a secondary practice location in Clinton Township, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1720646375

Entity TypeIndividualMale

Primary Taxonomy363LA2100X

Provider Legal NamePATRICK KENNEDY

Location Address11800 E 12 MILE RDWarren, MI 48093-3472

Mailing Address1 Ford Pl Ste 3aDetroit, MI 48202-3450 · (313) 874-4806

Phone(586) 573-5000

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateMay 30, 2019

Last NPPES UpdateJuly 27, 20262 updates tracked since enumeration

NPPES CertifiedJuly 27, 2026

✔ NPI 1720646375 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in MI · 4704301492

11800 E 12 MILE RD, Warren, MI 48093

Open in Google Maps ↗

Secondary Practice Location 1

Location 115855 19 Mile RdClinton Township, MI 48038-3504 · Phone (586) 263-2320 ext. 32300

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID7113409608

PECOS Enrollment IDI20260304001769

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 Reassignments

Medicare enrollment records show Patrick Kennedy reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Henry Ford Health Macomb-Oakland Hospital

Same address

Family Medicine

11800 E 12 MILE RD
Warren, MI 48093

Reassigned Medicare billing, Michigan enrollment
161 clinicians in this Medicare group

NPI 1134176472 (586) 573-5000

Henry Ford Macomb Hospital Corporation

7.9 mi

Neonatal

15855 19 MILE RD
Clinton Township, MI 48038

Reassigned Medicare billing, Michigan enrollment
215 clinicians in this Medicare group

NPI 1912301094 (586) 263-2300

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48093 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. MICHEAL BUGGIA M.D.

Emergency Medicine