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

Elizabeth Kennedy

Individual provider Surgical Physician Assistant · NPI 1982069860

Elizabeth Kennedy is a Physician Assistant in Brightwaters, New York. Qualified in 2016, 10 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment.

Years since qualifying
10
In the registry since
2015

Practice location Address checks out

404 Potter Blvd
Brightwaters, NY 11718-1830
Phone: (631) 376-0055
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X

Record details

NPI number1982069860
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 21, 2015
Last updated in NPPESDecember 10, 2019
Certification dateDecember 10, 2019
Mailing address23 Roosevelt Dr, Bethpage, NY 11714-5537

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare