Tracy Kennelley, P.A-C
NPI 1639507288ActiveIndividual· Physician Assistant· Bend, OR
Physician Assistant (P.A-C) with St Charles Health System Inc, practicing in Bend, Oregon. Mostly services rather than prescriptions: Medicare paid $27,629 for 278 patients in 2024, with only 49 Part D claims. Depuy Synthes Sales Inc. reported $96.11 in payments in 2025, mostly food and beverage. Lists St Charles Medical Center - Bend and 1 other hospital as hospital affiliations.
Overview
| NPI | 1639507288 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | P.A-C |
| Sole proprietor | No |
| NPI issued | Oct 17, 2013 |
| Last updated in NPPES | Jul 8, 2026 |
| Certified by provider | Jul 8, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | PA167858 | OR |
| Physician Assistant | 363A00000X | 51221 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (OR) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 278 |
|---|---|
| Services billed | 544 across 21 procedure codes |
| Paid by Medicare | $27,629 |
Part D prescriptions in 2024
| Prescriptions (claims) | 49 · 50 30-day fills |
|---|---|
| Patients | 21 |
| Total drug cost | $1,142 |
| Generic share | 76% of claims |
Education and affiliations
| Graduation year | 2013 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- St Charles Health System IncBend, OR · 377 clinicians
Hospital affiliations
- St Charles Medical Center - BendBend, OR
- St Charles Medical Center PrinevillePrineville, OR
Industry payments (Open Payments)
- 2025$96.11 · 1 payment from 1 company
- 2024$148.38 · 1 payment from 1 company
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Depuy Synthes Sales Inc. | $96.11 | 1 |
What the 2025 payments were for
- Food and Beverage$96.11 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other Physician Assistant providers in Bend
- 1881960979
- 1629896022
- 1326720186
- 1598570939
- 1861291106
- 1316682958
- 1730360546
- 1427673318
- 1346315868
- 1750536868
- 1104139369
- 1386023208