Mr Kenneth Willoughby Jr, PA-C - Medicare Physician Assistant in Avon Lake, OH

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Mr Kenneth Willoughby Jr, PA-C is a medicare enrolled "Physician Assistant" in Avon Lake, Ohio. His current practice location is 32051 Grove St, Avon Lake, Ohio. You can reach out to his office (for appointments etc.) via phone at (440) 930-2802.

Mr Kenneth Willoughby Jr is licensed to practice in South Carolina (license number 4370) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1427240019.

Contact Information

Mr Kenneth Willoughby Jr, PA-C
32051 Grove St,
Avon Lake, OH 44012-1906
(440) 930-2802
Not Available

Map and Direction




Provider's Profile

Full NameMr Kenneth Willoughby Jr
GenderMale
SpecialityPhysician Assistant
Location32051 Grove St, Avon Lake, Ohio
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1427240019
  • Provider Enumeration Date: 08/16/2007
  • Last Update Date: 05/06/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 8224925623
  • Enrollment ID: I20150820012488

Medical Identifiers

Medical identifiers for Mr Kenneth Willoughby Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1427240019NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AM0700XPhysician Assistant - Medical (* (Not Available))Secondary
363A00000XPhysician Assistant 4370 (South Carolina)Primary

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. Mr Kenneth Willoughby Jr 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 AddressPractice Location Address
Mr Kenneth Willoughby Jr, PA-C
32051 Grove St,
Avon Lake, OH 44012-1906

Ph: (440) 930-2802		Mr Kenneth Willoughby Jr, PA-C
32051 Grove St,
Avon Lake, OH 44012-1906

Ph: (440) 930-2802

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.