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

Individual provider Physician Assistant · NPI 1639507288

Tracy Kennelley, PA-C is a Physician Assistant in Bend, Oregon. Qualified in 2013, 13 years ago. Practices with St Charles Health System Inc, a 383-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California and Oregon.

Years since qualifying
13
Licensed in
CA, OR
In the registry since
2013
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2200 NE Neff Rd Ste 200
Bend, OR 97701-4281
Phone: (541) 382-3344
Fax: (541) 382-1681
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1150 N Indian Canyon Dr, Palm Springs, CA 92262-4872 — (760) 323-6511

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA167858 (OR)
Physician Assistant Taxonomy 363A00000X · Licence 51221 (CA)

Record details

NPI number1639507288
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 17, 2013
Last updated in NPPESJuly 8, 2026
Certification dateJuly 8, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice St Charles Health System Inc — 383 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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