Nicole Lynette Kennedy, MD in Marion, IL - Medicare Family Practice

Nicole Lynette Kennedy, MD is a medicare enrolled "Family Medicine" physician in Marion, Illinois. She went to University Of Illinois College Of Med (chi/peor/rock/chm-urb) and graduated in 2010 and has 14 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Deaconess Illinois Clinic Inc and her current practice location is 3411 Professional Park Drive, Simca, Marion, Illinois. You can reach out to her office (for appointments etc.) via phone at (618) 997-2161.

Nicole Lynette Kennedy is licensed to practice in Illinois (license number 036132187) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1780902486.

Contact Information

	Nicole Lynette Kennedy, MD
	3411 Professional Park Drive, Simca, Marion, IL 62959
	(618) 997-2161
	(618) 997-2464

Map and Direction

Physician's Profile

Full Name	Nicole Lynette Kennedy
Gender	Female
Speciality	Family Practice
Experience	14 Years
Location	3411 Professional Park Drive, Marion, Illinois
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Nicole Lynette Kennedy attended and graduated from University Of Illinois College Of Med (chi/peor/rock/chm-urb) in 2010

NPI Data:

NPI Number: 1780902486
Provider Enumeration Date: 05/06/2010
Last Update Date: 08/21/2023

Medicare PECOS Information:

PECOS PAC ID: 4183893431
Enrollment ID: I20131009000357

Medical Identifiers

Medical identifiers for Nicole Lynette Kennedy such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1780902486	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	32561 (South Carolina)	Secondary
208M00000X	Hospitalist	036132187 (Illinois)	Secondary
207Q00000X	Family Medicine	036132187 (Illinois)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Lhc-illinois Home Health Care	Marion, IL	Home health agency
Hospice Of Southern Ill, Inc	Belleville, IL	Hospice
Heartland Regional Medical Center	Marion, IL	Hospital
Southern Illinois Hospital Services Dba Herrin Hospital	Herrin, IL	Hospital
Memorial Hospital Of Carbondale	Carbondale, IL	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Deaconess Illinois Clinic Inc	5092187021	21

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. Nicole Lynette Kennedy allows following entities to bill medicare on her behalf.

Entity Name	Deaconess Illinois Clinic Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1962128256 PECOS PAC ID: 5092187021 Enrollment ID: O20230220002667

Entity Name	Deaconess Illinois Crossroads Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1528785284 PECOS PAC ID: 0143692178 Enrollment ID: O20230221000097

Entity Name	Deaconess Illinois Specialty Clinic, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1972210235 PECOS PAC ID: 9830562016 Enrollment ID: O20230321001688

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. Nicole Lynette 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 Address	Practice Location Address
Nicole Lynette Kennedy, MD 3411 Professional Park Drive, Simca, Marion, IL 62959 Ph: (618) 997-2161	Nicole Lynette Kennedy, MD 3411 Professional Park Drive, Simca, Marion, IL 62959 Ph: (618) 997-2161

Reviews and Comments

Family Medicine Doctors in Marion, IL

Robert Joseph Tiffin Jr., MD Family Medicine Medicare: Medicare Enrolled Practice Location: 2401 W Main St, Veterans Admin Hosp, Marion, IL 62959 Phone: 618-998-5617 Fax: 618-998-5697
Douglas C Brown, D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 1506 N.sioux Dr, Marion, IL 62959 Phone: 618-519-9200 Fax: 618-985-9155
Dr. Casie E Mosley, D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 2401 W Main St, Marion, IL 62959 Phone: 618-997-5311
Dr. Meshach Vedanayagam Samuel, Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2401 W Main St, Marion, IL 62959 Phone: 618-997-5311
Christopher Glazik Jr., FNP-BC Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2401 W Main St, Marion, IL 62959 Phone: 618-997-5311
Dr. Renato Ralota Katubig, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1008 West Cherry Street, Suite B, Marion, IL 62959 Phone: 618-993-0404 Fax: 618-993-1717
Shobha Dayal, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 2401 W Main St Dept Of, Marion, IL 62959 Phone: 618-997-5311

Nicole Lynette Kennedy, MD - Medicare Family Practice in Marion, IL