ELIZABETH LYNN KENNEDY (DO) – Family Medicine Physician, NPI 1215007414

ELIZABETH LYNN KENNEDY (DO) is a healthcare provider. based in Excelsior, Minnesota. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. MN52471 (MN). The NPI Number for ELIZABETH LYNN KENNEDY (DO) is 1215007414

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
ELIZABETH LYNN KENNEDY (DO)
NPI
1215007414
Phone
(952) 906-7855
Address
675 WATER ST
Enumeration Date
8 November 2006
Last Update Date
9 February 2012

Doctor Profile

Medical School Name
KANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
Secondary Phone
9529067855
Graduation Year
2002 (24 years ago)
PAC ID
4880696657
Group Practice PAC ID
9234041997
Professional Enrollment ID
I20100120000889
Address ID
MN553313072EX675XXSTXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:19State licenses:2Digital endpointsOther names

3,076 FAMILY PRACTICE in MN

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Provider Addresses for ELIZABETH LYNN KENNEDY (DO)

  • Ridgeview Excelsior Clinic, 675, Water Street, Excelsior, Hennepin County, Minnesota, 55331, United States

    EXCELSIOR, MN 553313072

    Phone: (952) 906-7855

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-01-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100120000889IFamily PracticeMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes197117$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit121121$0
99215Established patient office or other outpatient visit, 40-54 minutes10770$0
99213Established patient office or other outpatient visit, 20-29 minutes2726$0
72100X-ray of lower and sacral spine, 2-3 views1111$0
View full utilization report →

Insurance plans in this area (ZIP 55331)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9234041997View full group profile
NameSpecialtyState
Family PracticeMN
Internal MedicineMN
Family PracticeMN
-MN
-MN
Physician AssistantMN
Diagnostic RadiologyMN
Marriage And Family TherapistMN
Physician AssistantMN
Nurse PractitionerMN

Reviews

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Frequently asked questions

What is the standard ID for ELIZABETH LYNN KENNEDY (DO) in the U.S.?
In the U.S., ELIZABETH LYNN KENNEDY (DO) is identified by NPI 1215007414.
Should I treat ELIZABETH LYNN KENNEDY (DO) as an active provider?
Patients and plans typically see ELIZABETH LYNN KENNEDY (DO) as active in the national extract.
What does the directory say ELIZABETH LYNN KENNEDY (DO) does?
Insurance directories may phrase it differently, but here ELIZABETH LYNN KENNEDY (DO) maps to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to ELIZABETH LYNN KENNEDY (DO)?
ELIZABETH LYNN KENNEDY (DO) shows a connection to Excelsior, Minnesota in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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