JUSTIN MICHAEL KENNEDY (PA-C) – Physician Assistant, NPI 1528415767
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JUSTIN MICHAEL KENNEDY (PA-C)
5845, Pinebrook Drive, The Colony, Denton County, Texas, 75056, United States
THE COLONY, TX 750563859
Phone: (817) 845-5114
Type: Mailing
2020 W ST HWY 114
SUITE 120
GRAPEVINE, TX 760518649
Phone: (817) 912-8300
Fax: (817) 912-8310
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $106.
Total Amount is formed as General ($106) + Research ($0) + Ownership ($0) = $106.
Last reported payment date: 2024-08-22 • Largest payer in this snapshot: Davol Inc. ($86).
Total Amount
$106
General + Research + Ownership
Payments
2
Total payment records
General Amount
$106
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Davol Inc. | $86 |
| ABIOMED | $20 |
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: 2016-08-10
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160810000442 | I | Physician Assistant | TX | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99284 | Emergency department visit with moderate level of medical decision making | 48 | 46 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 14 | 14 | $0 |
Insurance plans in this area (ZIP 75056)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | TX | 81002 | Urinalysis, manual test | 15 | 15 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Radiation Oncology | TX | |
| Nurse Practitioner | TX | |
| Internal Medicine | TX | |
| - | TX | |
| - | TX | |
| Clinical Social Worker | TX | |
| - | TX | |
| Nurse Practitioner | TX | |
| Orthopedic Surgery | TX | |
| Clinical Psychologist | TX |
Reviews
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