Individual provider Active NPI

Kenneth Glen Wys, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Indio, CA
National Provider Identifier
1003929712
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
A64344 Issued in CA
Practice address
47111 Monroe St
Indio, CA 92201-6739
Phone
(760) 347-6191
Fax
(760) 775-8017
NPI assigned
Aug 16, 2006
Last updated
Jan 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A64344 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A64344 CA Primary

Addresses

Primary practice location

47111 Monroe St
Indio, CA 92201-6739

Mailing address

47111 Monroe St
Indio, CA 92201-6739
Phone (760) 347-6191

Other practice location 1

221 S Painted Mountain Dr
Las Vegas, NV 89148-2722
Phone (323) 842-3442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, HI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040211001193 CA Practitioner - Anesthesiology 6608760459 Reassigns benefits to 9 organizations
I20240712003503 HI Practitioner - Anesthesiology 6608760459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of California, Davis School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hilo Benioff Medical CenterGroup PAC ID 1254422900, shared by 4 NPIs, 131 clinicians
HP Anesthesia IncGroup PAC ID 6608009766, 34 clinicians
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians
Bright Anesthesia a Professional CorporationGroup PAC ID 4183114028, 14 clinicians

Practice addresses (Care Compare)

1190 Waianuenue Ave
Hilo, HI 96720-2089
Phone (808) 932-3000

1300 N Vermont Ave
Los Angeles, CA 90027-6098
Phone (213) 413-3000

16543 Carmenita Rd
Cerritos, CA 90703-2218
Phone (562) 219-7251

4650 Lincoln Blvd
Marina del Rey, CA 90292-6306
Phone (310) 823-8911

6801 Park Ter
Suite 300
Los Angeles, CA 90045-9212
Phone (310) 665-7150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

Merit-based Incentive Payment System (MIPS)

Final score
88.39 of 100Reported as group
Quality
79.9
Promoting interoperability
99
Improvement activities
40
Cost
82.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A64344CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coachella Valley Anesthesia a Professional Corporation Anesthesiology CurrentSince Dec 29, 2023 Accepting new patients
First Choice Physician Partners Current Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Aug 1, 2024 Accepting new patients
Kauai Medical Clinic CurrentSince May 4, 2024 Accepting new patients
Bright Anesthesia a Professional Corporation Anesthesiology CurrentSince Aug 25, 2025 Accepting new patients
First Choice Physician Partners CurrentSince Oct 1, 2019 Accepting new patients
Kenneth G Wys MD PC CurrentSince Jan 12, 2020 Accepting new patients
Willow Brook Critical Care Medical Group, Inc CurrentSince Jul 1, 2020 Accepting new patients
Kauai Medical Clinic CurrentSince May 4, 2024 Accepting new patients
First Choice Physician Partners CurrentSince Oct 1, 2019 Accepting new patients
Vista Critical Care Associates Inc Critical Care Medicine CurrentSince Jan 1, 2022 Accepting new patients
HP Anesthesia Inc Anesthesiology CurrentSince Jul 1, 2022 Accepting new patients
Sheridan Drozdow Healthcare of Nevada PC Anesthesiology Past Accepting new patients
Palm Springs Anesthesia Services, PC Anesthesiology Past Accepting new patients
Sheridan Healthcare of Washington, PC Anesthesiology Past Accepting new patients
Kapiolani Medical Center for Women & Children Past Accepting new patients
Olympic Anesthesia Partnership Anesthesiology PastSince Apr 30, 2003 Accepting new patients
First Choice Physician Partners Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

16543 Carmenita Rd
Cerritos, CA 90703
Phone (562) 219-7251

1420 S Central Ave
Glendale, CA 91204
Phone (818) 502-1900

1511 W Glenoaks Blvd
Glendale, CA 91201
Phone (818) 637-2200

47111 Monroe St
Indio, CA 92201
Phone (760) 347-6191

47111 Monroe St
#F
Indio, CA 92201
Phone (760) 347-6191

5 Holland
Ste 101
Irvine, CA 92618
Phone (949) 588-2199

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

10904 Reagan St
Los Alamitos, CA 90720
Phone (562) 592-3140

10904 Reagan St
#1182
Los Alamitos, CA 90720
Phone (562) 596-3140

3751 Katella Ave
Los Alamitos, CA 90720
Phone (562) 799-3160

1300 N Vermont Ave
Los Angeles, CA 90027
Phone (213) 413-3000

6801 Park Ter
Ste 300
Los Angeles, CA 90045
Phone (310) 655-7200

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

4553 Glencoe Ave
Ste 100
Marina del Rey, CA 90292
Phone (310) 613-9688

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

1150 N Indian Canyon Dr
#1112
Palm Springs, CA 92262

35800 Bob Hope Dr
Ste 225
Rancho Mirage, CA 92270
Phone (760) 324-4466

4650 Lincoln Blvd
Venice, CA 90292
Phone (310) 264-2561

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

Organizations & group practices 19

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 19

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1003929712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47111 MONROE ST",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922016739",
            "telephone_number": "760-347-6191",
            "fax_number": "760-775-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47111 MONROE ST",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922016739",
            "telephone_number": "760-347-6191",
            "fax_number": "760-775-8017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 S Painted Mountain Dr",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891482722",
            "country_code": "US",
            "telephone_number": "323-842-3442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYS",
        "first_name": "KENNETH",
        "middle_name": "GLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A64344",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A64344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

Verify at the official NPI Registry.