Dr Ethan Owen Kennedy, DO - Medicare Family Practice in Phoenix, AZ

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Dr Ethan Owen Kennedy, DO is a medicare enrolled "Family Medicine" physician in Phoenix, Arizona. He went to Kansas City University Of Med & Biosciences, College Of Osteo Med and graduated in 1995 and has 29 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Healthy Life Corporation and his current practice location is 10240 W Indian School Rd Ste 155, Phoenix, Arizona. You can reach out to his office (for appointments etc.) via phone at (623) 385-7900.

Dr Ethan Owen Kennedy is licensed to practice in Arizona (license number 3123) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1972679181.

Contact Information

Dr Ethan Owen Kennedy, DO
10240 W Indian School Rd Ste 155,
Phoenix, AZ 85037-5909
(623) 385-7900
(623) 440-4360

Map and Direction




Physician's Profile

Full NameDr Ethan Owen Kennedy
GenderMale
SpecialityFamily Practice
Experience29 Years
Location10240 W Indian School Rd Ste 155, Phoenix, Arizona
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Ethan Owen Kennedy attended and graduated from Kansas City University Of Med & Biosciences, College Of Osteo Med in 1995
  NPI Data:
  • NPI Number: 1972679181
  • Provider Enumeration Date: 11/28/2006
  • Last Update Date: 12/20/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 1658353644
  • Enrollment ID: I20040603000546

Medical Identifiers

Medical identifiers for Dr Ethan Owen Kennedy such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1972679181NPI-NPPES
452673MedicaidAZ

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 3123 (Arizona)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Ethan Owen Kennedy allows following entities to bill medicare on his behalf.
Entity NameUrgent Care Centers Of Arizona, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013421429
PECOS PAC ID: 5890971097
Enrollment ID: O20110524000733
Entity NameCeb Capital Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750754982
PECOS PAC ID: 0244537561
Enrollment ID: O20160330002570
Entity NameHealthy Life Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1548510365
PECOS PAC ID: 9739353061
Enrollment ID: O20160524000616

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Ethan Owen Kennedy is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Ethan Owen Kennedy, DO
10240 W Indian School Rd Ste 155,
Phoenix, AZ 85037-5909

Ph: (623) 385-7900		Dr Ethan Owen Kennedy, DO
10240 W Indian School Rd Ste 155,
Phoenix, AZ 85037-5909

Ph: (623) 385-7900

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.