Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Kenneth Richard Phelps , PA-C

Physician Assistant โ€ข Jacksonville, FL

Active NPI 1669807210 Individual Practitioner Male Practitioner Accepts Medicare assignment
Practice location in NPPES

3599 University Blvd S, Bldg. 300
Jacksonville, FL 322164252

Call 9043995550 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

3599 University Blvd S
Bldg. 300

Jacksonville, FL 322164252

Telephone 9043995550
Fax 9043464334
Organization at the Same NPPES Address or Phone
Bagnoli And Salah Partnership Facility NPI 1144287335

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Summit Radiology Services P C. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Medical School

At Still University, Arizona School Of Dentistry & Oral Hlth

Graduation Year

2013

Medicare patients

181 people with Original Medicare in 2024

Different Original Medicare patients in 2024; counts below 11 are hidden; this does not show availability or quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider, 2024.

Medicare-allowed amount

About $26,691 in 2024

The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.

What this does not show: Medicare-allowed amount

This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

Paid by Medicare

About $21,107 in 2024

The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.

What this does not show: Paid by Medicare

This is not the clinician's income and not a measure of quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

30-day fills

16 standardized 30-day fills in 2015

CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.

What this does not show: 30-day fills

It is not a count of patients and not a measure of quality.

Part D drug cost

$29,744 in 2015

The total cost of these prescriptions in 2015, paid by Medicare drug plans, patients and other payers together.

What this does not show: Part D drug cost

A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.

Source: CMS, Medicare Part D Prescribers โ€“ by Provider and Drug, 2015.

Industry payments (Open Payments)

Fewer than 11 payment records totaling $23.63 in 2024

Drug and medical device companies must report certain payments to doctors and some other clinicians to CMS, such as meals, travel, speaking fees or research funding.

These records are submitted by drug and medical device companies, and a reported payment does not necessarily mean the financial relationship is improper.

General: payments not tied to research, such as meals, travel, consulting or speaking fees.

A reported payment does not necessarily mean the financial relationship is improper. Research payments can go to a hospital or university for a study the clinician leads, not to the clinician personally. Clinicians can dispute records with the company that reported them.

Source: CMS Open Payments, program year 2024.

Guide: How to read an Open Payments record

Years since graduation

13 years (graduated 2013)

CMS Doctors and Clinicians data list 2013 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2013

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, โ€œDoes your provider accept Medicare as full payment?โ€

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Kenneth Phelps has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Kenneth Phelps as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Jacksonville and Florida

Billing and prescribing volume is not a quality rating.

Medicare Part B services

Close to the middle for clinicians listed under Physician Assistant in Jacksonville, FL (2024, 432 clinicians with data). Median for this group: 317. Middle half: 110 to 886.

Close to the middle for clinicians listed under Physician Assistant in Florida (2024, 4,397 clinicians with data). Median for this group: 252. Middle half: 82 to 807.

Medicare-allowed amount

Close to the middle for clinicians listed under Physician Assistant in Jacksonville, FL (2024, 432 clinicians with data). Median for this group: $25,236. Middle half: $8,783 to $61,231.

Close to the middle for clinicians listed under Physician Assistant in Florida (2024, 4,397 clinicians with data). Median for this group: $19,984. Middle half: $7,371 to $51,670.

Paid by Medicare

Close to the middle for clinicians listed under Physician Assistant in Jacksonville, FL (2024, 432 clinicians with data). Median for this group: $18,850. Middle half: $6,720 to $45,820.

Close to the middle for clinicians listed under Physician Assistant in Florida (2024, 4,397 clinicians with data). Median for this group: $14,814. Middle half: $5,414 to $38,190.

Medicare Part D

Comparisons use 2024 data. The latest CMS data for Kenneth Phelps are from 2015.

842 active clinicians are listed under Physician Assistant with a practice address in Jacksonville, FL (10,260 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Jacksonville

20.5% of these 842 clinicians have the CMS telehealth indicator.

59.1% of these 842 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2015), CMS Open Payments (2024), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo ยท Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments ยท Program Year 2024
Disclosure Year:

Program year 2024 (payments made January 1 โ€“ December 31, 2024): fewer than 11 records totaling $23.63.

Manufacturer Payment Nature Product Type Amount ($)
Medtronic, Inc.
Food and Beverage
In-kind items and services
CONCERTOTM General $23.63

Source: CMS Open Payments, program year 2024, released June 30, 2026.

Performed Procedures & Service Volume

Services billed to Original Medicare Part B in 2024.

CMS Part B ยท Data Year 2024
Reporting Year:

CPTยฎ is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2016โ€“2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners โ€“ by Provider and Service data, 2017โ€“2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

HCPCS Code Services Patients Submitted Charge Medicare Allowed
77001 Fluoroscopic guidance for insertion or removal of central vein access device
83 69 $65.00 $14.77
76937 Ultrasonic guidance for blood vessel access
65 59 $49.00 $11.43
32555 Aspiration of fluid from chest cavity using imaging guidance
44 38 $391.00 $88.96
36558 Insertion of tunneled central venous tube for infusion (5 years or older)
42 41 $917.00 $211.95
49083 Drainage of fluid from abdominal cavity using imaging guidance
40 20 $375.00 $85.96
99152 Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes
27 27 $43.00 $10.04
38222 Biopsy and aspiration of bone marrow sample for diagnosis
20 19 $272.00 $61.80
36556 Insertion of non-tunneled central venous tube for infusion (5 years or older)
18 18 $298.00 $69.60
77012 Review by radiologist of ct guidance for needle placement
18 17 $253.00 $57.00
10005 Fine needle aspiration biopsy using ultrasound guidance, first growth
14 14 $256.00 $60.32
36561 Insertion of central venous tube with port (5 years or older)
14 14 $1183.00 $274.10

Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits

Submitted charges are billed amounts, not a price quote for your visit.

Medicare Part D Prescribing Profile & Medications

Medicare Part D prescriptions filled, including refills, in 2015.

CMS Part D ยท Data Year 2015
Prescription Year:
Brand Name Generic Name Prescriptions Day Supply Total Cost Patients
Forteo Teriparatide 12 476 $29,743.52 โ€”

Source: CMS Part D by Provider and Drug, 2015; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-02-26
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES FL PA9107403

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PHYSICIAN ASSISTANT

Medicare Enrollment ID

I20170724001546

Enrollment State Jurisdiction

GA

PECOS Control ID

7618103193

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Summit Radiology Services P C

1266 Hwy 515 S, Jasper, GA 301434872

Phone: 7706077339

Summit Radiology Services P C

1133 Eagles Landing Pkwy, Stockbridge, GA 302815085

Phone: 6786041000

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

40 listed
Dr. Mary Alderman , MD

Radiology - Diagnostic Radiology

NPI 1093737306

Doctor of Medicine (M.D.)

Dr. Shannon Beardsley , MD

Radiology - Diagnostic Radiology

NPI 1649292954

Doctor of Medicine (M.D.)

Dr. Sudha Bogineni-Misra , MD

Radiology - Diagnostic Radiology

NPI 1922068956

Doctor of Medicine (M.D.)

Dr. Michael Borbely , MD

Radiology - Diagnostic Radiology

NPI 1255352662

Doctor of Medicine (M.D.)

Bonnie Brogdon , PA-C

Physician Assistant

NPI 1720445943

Physician Assistant (Certified)

Dr. Richard Buxton , MD

Radiology - Diagnostic Radiology

NPI 1174544522

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
๐Ÿ“
Updated Business Mailing Address February 26, 2021

Registered at PO BOX 200096, CARTERSVILLE, GA 301209002 (Tel: 6789057053)

โœ…
NPI Profile Active September 13, 2013

NPI status registered as active in NPPES database

๐Ÿ“
Practice Location (Initial Record) September 13, 2013

Registered at 3599 UNIVERSITY BLVD S, BLDG. 300, JACKSONVILLE, FL 322164252 (Tel: 9043995550)

๐Ÿ“
Business Mailing Address (Initial Record) September 13, 2013

Registered at 3599 UNIVERSITY BLVD S, BLDG. 300, JACKSONVILLE, FL 322164252 (Tel: 9043995550)

๐Ÿ‘ค
Provider Name / Credentials (Initial Record) September 13, 2013

Recorded as KENNETH PHELPS, PA-C

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 13, 2013

Physician Assistant (license number reported to NPPES: FL PA9107403)

๐ŸŸข
Initial NPI Registration & Enumeration September 13, 2013

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1669807210
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 13, 2013
Last Update: February 26, 2021
Sole Proprietor: No

Other Physician Assistants in Jacksonville

All Physician Assistants in Jacksonville

Mailing Address

Po Box 200096

Cartersville, GA 301209002

Phone: 6789057053

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.