Kenneth Melbourne Kroll, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

A18019 Issued in CA

Practice address

13010 Buckley St
Poway, CA 92064-5608

Phone

(702) 732-4515

NPI assigned

Apr 11, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1239408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239408000000",
    "number": "1154564847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 MOUNTAIN RD",
            "city": "JAFFREY",
            "state": "NH",
            "postal_code": "034525925",
            "telephone_number": "603-532-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13010 BUCKLEY ST",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920645608",
            "telephone_number": "702-732-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROLL",
        "first_name": "KENNETH",
        "middle_name": "MELBOURNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-11",
        "last_updated": "2009-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A18019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry T Konzen
• Ivy Koo
• Dale A Kooistra, M.D., PHD.
• Jessica Anne Kraker, M.S., CF-SLP
• Lea Catherine Kravis
• Michael Wayne Kruse, PHARM.D.
• Karen Kubischta, RDHAP
• Shraddha R Kulkarni
• Phyllis H Kuo, RPH
• Kassandra La Giusa-Riedeman

• Urology Physician in Poway, CA
• Providers in Poway, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.