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

Kevin Matthew Pennycook, DO

Individual provider Dermatology Physician · NPI 1922661040

Kevin Matthew Pennycook, DO is a Dermatology in Fort Myers, Florida. Graduated from Michigan State University College of Osteopathic Medicine in 2019, 7 years ago. Practices with Aqua Dermatology of Florida, PA, a 184-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
7
Trained at
Michigan State University College of Osteopathic Medicine
Licensed in
FL
In the registry since
2019
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

3268 Forum Blvd Ste 201
Fort Myers, FL 33905-5585
Phone: (239) 232-1176
Fax: (239) 244-9839
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence OS19718 (FL)

Record details

NPI number1922661040
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 15, 2019
Last updated in NPPESSeptember 1, 2023
Certification dateSeptember 1, 2023

Medicare enrollment

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

Medicare specialtyDERMATOLOGY
Medical schoolMICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2019 (7 years in practice)
Group practice Aqua Dermatology Of Florida, Pa — 184 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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