Individual provider Active NPI

Kenneth A Weller, M.D.

  • Family Medicine Physician
  • Highlands Ranch, CO
National Provider Identifier
1023016128
Registry record updated Sep 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36799 Issued in CO
Practice address
8925 Ridgeline Blvd
Suite 109
Highlands Ranch, CO 80129-2500
Phone
(303) 471-6500
Fax
(303) 471-5908
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36799 CO Primary

Addresses

Primary practice location

8925 Ridgeline Blvd
Suite 109
Highlands Ranch, CO 80129-2500

Mailing address

8925 Ridgeline Blvd
Suite 109
Highlands Ranch, CO 80129-2500
Phone (303) 471-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20061009000288 CO Practitioner - Family Practice 0345246799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
R Franklin University of Med & Sci/Chicago Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steffi Gratigny MD PCGroup PAC ID 4082610431, 2 clinicians

Practice addresses (Care Compare)

8925 S Ridgeline Blvd
Suite 109
Highlands Ranch, CO 80129-2502
Phone (303) 471-6500

Hospital & facility affiliations

  • Bayada Home Health Care Inc Home health agency, Denver, CO, CCN 067056
  • AdventHealth Littleton Hospital, Littleton, CO, CCN 060113

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions17
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36799COMDFamily Medicine Physician

Organizations & group practices 1

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.

Hospital & facility affiliations 8

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252540800000",
    "number": "1023016128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8925 RIDGELINE BLVD",
            "address_2": "SUITE 109",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292500",
            "telephone_number": "303-471-6500",
            "fax_number": "303-471-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8925 RIDGELINE BLVD",
            "address_2": "SUITE 109",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292500",
            "telephone_number": "303-471-6500",
            "fax_number": "303-471-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLER",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2009-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "36799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highlands Ranch, CO

Sources for this page

Verify at the official NPI Registry.