Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derek Kennedy

Individual provider Emergency Medicine Physician · NPI 1396088571

Derek Kennedy is an Emergency Medicine in Jamestown, New York. Graduated from Yale University School of Medicine in 2013, 13 years ago. Practices with Emergency Group of Arizona Professional Corporation, a 98-clinician group and accepts Medicare assignment. Licensed in Arizona and New York.

Years since qualifying
13
Trained at
Yale University School of Medicine
Licensed in
AZ, NY
In the registry since
2013
Specialties on file
2
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Practice location Address checks out

207 Foote Ave
Jamestown, NY 14701-7077
Phone: (716) 664-8120
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 292055 (NY)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 70765 (AZ)

Record details

NPI number1396088571
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 5, 2013
Last updated in NPPESOctober 6, 2023
Certification dateOctober 6, 2023
Mailing address5950 Bowman Rd, East Syracuse, NY 13057-9500

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolYALE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2013 (13 years in practice)
Group practice Emergency Group Of Arizona Professional Corporation — 98 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Jamestown