Dr Samantha Fugate Kennedy, DO is a medicare enrolled "Psychiatry & Neurology - Child & Adolescent Psychiatry" physician in Haslett, Michigan. Her current practice location is
1660 Haslett Rd, Haslett, Michigan. You can reach out to her office (for appointments etc.) via phone at
(517) 347-8420.
Dr Samantha Fugate Kennedy is licensed to practice in Michigan (license number 5101020751) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1154760312.
Physician's Profile
| Full Name | Dr Samantha Fugate Kennedy |
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| Gender | Female |
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| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
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| Location | 1660 Haslett Rd, Haslett, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1154760312
- Provider Enumeration Date: 06/21/2013
- Last Update Date: 02/09/2026
Medicare PECOS Information:
- PECOS PAC ID: 1850661679
- Enrollment ID: I20170726002725
Medical Identifiers
Medical identifiers for Dr Samantha Fugate Kennedy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1154760312 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 5101020751 (Michigan) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Samantha Fugate Kennedy allows following entities to bill medicare on her behalf.
| Entity Name | Community Mental Health Authority Of Clinton Eaton Ingham Counties |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1265483457 PECOS PAC ID: 2668376732 Enrollment ID: O20031120000698 |
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| Entity Name | Hurley Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1982630844 PECOS PAC ID: 2961308481 Enrollment ID: O20031208000375 |
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| Entity Name | Edward W Sparrow Hospital Association |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1831139088 PECOS PAC ID: 6709799166 Enrollment ID: O20040102000790 |
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| Entity Name | Montcalm Care Network |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1710074448 PECOS PAC ID: 8123000932 Enrollment ID: O20040623001391 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Samantha Fugate Kennedy is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Dr Samantha Fugate Kennedy, DO 1660 Haslett Rd Ste 1, Haslett, MI 48840-8469 Ph: (517) 347-8420 | Dr Samantha Fugate Kennedy, DO 1660 Haslett Rd, Haslett, MI 48840-8469 Ph: (517) 347-8420 |
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