Kevin X Mckennan
Otolaryngology (Otology & Neurotology)

Address: 1111 Exposition Blvd Bldg 700, Sacramento, CA 95815-4314
Phone: 9167363408

Kevin X Mckennan (NPI# 1356344022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1356344022
Entity Type Individual
Full Name Kevin X Mckennan
Credential MD
Gender Male
Practice Address 1111 Exposition Blvd Bldg 700
Sacramento
CA 95815-4314
Practice Telephone 9167363408
Practice Fax Number 9162334171
Mailing Address 1111 Exposition Blvd
Bldg 700
Sacramento
CA 95815-4300
Mailing Telephone 9167363399
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2005-05-24
Last Update Date 2018-10-04

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 207YX0901X Otolaryngology · Otology & Neurotology Allopathic & Osteopathic Physicians G40176 CA

Other Provider Identifier

State Identifier Issuer Type Code
CA 040003543 OTHER RR MEDICARE PIN

Physician Overview

NPI 1356344022
PAC ID by PECOS 2365511409
Professional Enrollment ID I20081223000221
Full Name Kevin X Mckennan
Organization Legal Name SACRAMENTO EAR NOSE AND THROAT SURGICAL AND MEDICAL GROUP INC
Phone Number 9167363399
Gender M
Medical School ALBANY MEDICAL COLLEGE OF UNION UNIVERSITY
Graduation Year 1978
Primary Specialty OTOLARYNGOLOGY
Group Practice PAC ID 6204905342
Number of Group Practice Members 31
Accepts Medicare Assignment Y
Report Quality Measures Y
Use Electronic Health Records Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
050108 SUTTER MEDICAL CENTER, SACRAMENTO
050017 MERCY GENERAL HOSPITAL

Office Location

Street Address 1111 EXPOSITION BLVD BLDG 700
City SACRAMENTO
State CA
Zip Code 95815-4314

Providers in the same location

NPI Name Taxonomy Address Enumeration
1023509734 Kimberly Tersilla Ledda Audiologist 1111 Exposition Blvd Bldg 700, Sacramento, CA 95815-4314 2018-05-29
1568972941 Andrea N Knapp Audiologist 1111 Exposition Blvd Bldg 700, Sacramento, CA 95815-4314 2017-10-11
1962846949 Conor William Mclaughlin Student in an Organized Health Care Education/Training Program 1111 Exposition Blvd Bldg 700, Sacramento, CA 95815-4314 2013-04-22
1376703454 Brent Jason Benscoter Otolaryngology 1111 Exposition Blvd Bldg 700, Sacramento, CA 95815-4314 2008-06-12

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1669941159 Maria Luisa Plasencia Registered Nurse Martin Luther King Jr. Technology Academy, 3051 Fairfield St, Sacramento, CA 95815 2018-11-14
1700386547 Rww Outpatient Rehab Services, LLC Clinic/Center 1610 Arden Way Ste 195, Sacramento, CA 95815 2018-02-19
1114439262 Ahc Healthcare of Sacramento Corporation Skilled Nursing Facility 1411 Expo Pkwy, Sacramento, CA 95815 2017-10-30
1588173686 Rebekah Collette Curtis Counselor 1048 Dixieanne Ave. #28, Sacramento, CA 95815 2017-09-21
1497284145 Prohealth Home Care Inc Hospice Care, Community Based 1375 Exposition Blvd Suite 250b, Sacramento, CA 95815 2017-06-07
1386982296 Shailesh M Asaikar Md Inc Clinic/Center 1111 Exposition Blvd., Bldg 700, Sacramento, CA 95815 2013-01-28
1609129618 Jackey Care's Housing Clinic/Center 2447 Boxwood St, Sacramento, CA 95815 2012-10-16
1144549304 Rowena Deleon Nolasco Nurse Practitioner 577 Las Palmas Ave., Health for All, Sacremento, CA 95815 2010-05-26
1659409027 Amy Ann Smith Social Worker 1955 Canterbury Rd, Sacramento, CA 95815 2007-02-28
1194871152 Nivano Physicians, Inc. Health Maintenance Organization 1420 River Park Dr Ste 200, Sacramento, CA 95815 2007-01-25
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Taxonomy Information

Taxonomy Code 207YX0901X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology
Specialization Otology & Neurotology

Taxonomy Definition

An otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology and neurotology emphasizes the study of embryology, anatomy, physiology, epidemiology, pathophysiology, pathology, genetics, immunology, microbiology and the etiology of diseases of the ear and temporal bone.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1700151909 Stuart Gerard Gherini Otolaryngology 1056 38th St, Sacramento, CA 95816-5513 2012-03-20
1376703454 Brent Jason Benscoter Otolaryngology 1111 Exposition Blvd Bldg 700, Sacramento, CA 95815-4314 2008-06-12
1407820095 Hilary Alan Brodie Otolaryngology 2521 Stockton Blvd, Suite 7200, Sacramento, CA 95817-2207 2006-02-13
1003890559 Robert Dobie Otolaryngology 2521 Stockton Blvd, Suite 7200, Sacramento, CA 95817-2207 2005-11-29

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1699017301 Shohet Ear Associates Medical Group Inc Otolaryngology 770 Pacific Coast Hwy, Seal Beach, CA 90740-6379 2013-03-20
1801152665 Center for Fall Prevention, A Medical Corporation Otolaryngology 3831 Hughes Ave Ste 608, Culver City, CA 90232-6851 2012-04-05
1427387547 Ashley Erin Balaker Otolaryngology 24411 Health Center Dr Ste 370, Laguna Hills, CA 92653-3687 2009-12-19
1144420738 Shohet Ear Associates Medical Group Inc Otolaryngology 446 Old Newport Beach Blvd, Shohet Ear Associates Medical Group Inc, Newport Beach, CA 92663-4246 2007-07-20
1740308907 Juan Miguel Andrade Otolaryngology 2613 Saturn Avenue, Huntington Park, CA 90255 2007-03-27
1952426017 Hernan Goldsztein Otolaryngology 530 Lomas Santa Fe Dr Ste 1, Solana Beach, CA 92075-1350 2007-03-20
1932253960 Hana T. Bui, Md, A Professional Corporation Otolaryngology 1321 N Harbor Blvd Ste 101, Fullerton, CA 92835-4129 2007-01-23
1508876699 Derald E Brackmann Otolaryngology 2100 W 3rd St Ste 111, Los Angeles, CA 90057-1999 2006-08-09
1235144742 Anh T. Nguyen-huynh Otolaryngology 4900 W Sunset Blvd Fl 6, Los Angeles, CA 90027-5814 2006-07-31
1699288027 Haley Morgan Roberson Otolaryngology 1900 University Ave Ste 101, East Palo Alto, CA 94303-2213 2017-11-07
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City SACRAMENTO
Zip Code 95815

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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