Kevin Mark Senn, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

183438 Issued in NY

Practice address

707 SW Gaines St.
CDRC
Portland, OR 97239-3098

Phone

(503) 494-1619

Fax

(503) 494-6868

NPI assigned

Apr 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in OR

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ksennmd40790@direct.ohsu.edu

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

• University Professional Services

  • General Practice Physician
  • Portland, OR
  • NPI 1376709535
  Medicare reassignment NPD
• University Professional Services

  • General Practice Physician
  • Bend, OR
  • NPI 1922255074
  NPD

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1013973668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 SW GAINES ST.",
            "address_2": "CDRC",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393098",
            "telephone_number": "503-494-1619",
            "fax_number": "503-494-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SW GAINES ST.",
            "address_2": "CDRC",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393098",
            "telephone_number": "503-494-1619",
            "fax_number": "503-494-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENN",
        "first_name": "KEVIN",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "183438",
            "primary": true
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "OR",
            "license": "153312",
            "primary": false
        },
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "NY",
            "license": "183438",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "183438",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426000235",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018547990001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01402900",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010162101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000511836003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426000240",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "1205731",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Senic
• Senior Haven LLC
• Melissa Ann Senn-Reis, ATC
• Carrie Elizabeth Senn, PHARMD
• Jordan L Senn, DO
• Sensory Kids, LLC
• Sara Sentell, N.D., L.AC.
• Mary Sents
• Seong W. Kim, DMD, LLC
• Mickey John Seppala, QMHA

• Pediatrics Physician in Portland, OR
• Providers in Portland, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.