Kan-Di-Ki LLC

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

KAN-DI-KI LLC

Doing business as

Diagnostic Laboratories
TridentCare

Practice address

11585 E 53Rd Ave Ste H
Denver, CO 80239-2321

Phone

(303) 371-0073

Fax

(443) 842-7264

NPI assigned

Dec 1, 2010

Last updated

Mar 10, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian C Cuomo

Title

Authorized Official/Cfo

Phone

(800) 786-8015

Specialties & licenses 1

Addresses

Other names 2

• Diagnostic Laboratories Doing business as
• TridentCare Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1104128859. Details of each certification follow.

• CCN 06X0009815 Portable X-ray supplier · Active · Name & address match · Details
• CCN 06X0009820 Portable X-ray supplier · Active · Name & address match · Details

Portable X-ray supplier certification: CCN 06X0009815

Legal name

DIAGNOSTIC LABORATORIES TRIDENTCARE AT HOME TRIDEN

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Sep 30, 2011

Last certification

Oct 24, 2018

Ownership / control type

Corporation

Facility address

11585 E 53Rd Ave Ste H
Denver, CO 80239

Portable X-ray supplier certification: CCN 06X0009820

Legal name

TRIDENTCARE

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Aug 13, 2020

Last certification

Aug 13, 2020

Ownership / control type

Corporation

Facility address

11585 E 53Rd Ave Ste H
Denver, CO 80239

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Kan-Di-Ki LLC

  dba Diagnostic Laboratories

  • Diagnostic Ultrasound Physician
  • Denver, CO
  • NPI 1871898841

  5991737140

  Same PAC ID
• Kan-Di-Ki LLC

  dba Diagnostic Laboratories

  • Diagnostic Ultrasound Physician
  • Portland, OR
  • NPI 1083926612

  5991737140

  Same PAC ID
• Kan-Di-Ki LLC

  dba Diagnostic Laboratories

  • Clinical Medical Laboratory
  • Irvine, CA
  • NPI 1093697757

  5991737140

  Same PAC ID
• Kan-Di-Ki LLC

  dba Diagnostic Laboratories

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Tukwila, WA
  • NPI 1124340039

  5991737140

  Same PAC ID
• Kan-Di-Ki LLC

  dba Diagnostic Laboratories

  • Diagnostic Ultrasound Physician
  • Tukwila, WA
  • NPI 1407151475

  5991737140

  Same PAC ID
• Kan-Di-Ki LLC

  dba Diagnostic Laboratories

  • Diagnostic Ultrasound Physician
  • Las Vegas, NV
  • NPI 1700198330

  5991737140

  Same PAC ID
• Kan-Di-Ki LLC

  dba Diagnostic Laboratories

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • North Hollywood, CA
  • NPI 1750364345

  5991737140

  Same PAC ID
• Kan-Di-Ki LLC

  dba Diagnostic Laboratories

  • Diagnostic Ultrasound Physician
  • Phoenix, AZ
  • NPI 1992017529

  5991737140

  Same PAC ID
• Kan-Di-Ki, LLC

  dba Diagnostic Laboratories

  • Diagnostic Ultrasound Physician
  • North Hollywood, CA
  • NPI 1548422488

  5991737140

  Same PAC ID
• Kan-Di-Ki, LLC

  dba Diagnostic Laboratories

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Las Vegas, NV
  • NPI 1811210289

  5991737140

  Same PAC ID
• Kan-Di-Ki, LLC

  dba Diagnostic Laboratories

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Portland, OR
  • NPI 1841514395

  5991737140

  Same PAC ID
• Kan-Di-Ki, LLC

  dba Diagnostic Laboratories

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Phoenix, AZ
  • NPI 1851613764

  5991737140

  Same PAC ID

Locations

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773100800000",
    "number": "1104128859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SCHILLING CIR STE 114",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210311113",
            "telephone_number": "800-786-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11585 E 53RD AVE STE H",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802392321",
            "telephone_number": "303-371-0073",
            "fax_number": "443-842-7264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12075 E 45th Ave Ste 700A",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802393123",
            "country_code": "US",
            "telephone_number": "303-371-0073",
            "fax_number": "443-842-7264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KAN-DI-KI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-01",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A",
        "authorized_official_last_name": "CUOMO",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/CFO",
        "authorized_official_telephone_number": "800-786-8015"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diagnostic Laboratories",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Diagnostic Laboratories",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TridentCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan Marie Kamler, LPC
• Barbara Kamlet, MA, NCC
• Daniel Terry Kamlet, P.A.
• Bethany Kammerer, LCSW
• Alissa Lee Kammerling
• Kan-Di-Ki LLC (Diagnostic Laboratories)
• Kanascripts, LLC
• Ernest W Kandel, MD
• Nicole Kandel
• Thomas Nicholas Kandravy

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Denver, CO
• Providers in Denver, CO by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.