Kenneth Pomar Rebong, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A045813 Issued in CA

Practice address

2350 McKee Rd
Suite 1
San Jose, CA 95116-1617

Phone

(408) 729-3232

Fax

(408) 729-2165

NPI assigned

Jul 31, 2006

Last updated

Apr 6, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Rebong Pediatric Medical Group, P.C.

  • Pediatrics Physician
  • San Jose, CA
  • NPI 1285855130
  Authorized official Same address or phone
• Anson Medical Inc

  • Primary Care Clinic/Center
  • San Jose, CA
  • NPI 1083051080
  NPD (past)
• County of Santa Clara

  dba Inpatient Acute/Outpatient Facility Services

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1063406551
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1326054776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 MCKEE RD",
            "address_2": "SUITE 1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161617",
            "telephone_number": "408-729-3232",
            "fax_number": "408-729-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 MCKEE RD",
            "address_2": "SUITE 1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161617",
            "telephone_number": "408-729-3232",
            "fax_number": "408-729-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBONG",
        "first_name": "KENNETH",
        "middle_name": "POMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": "A45813",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A045813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ivanna Reano
• Claudia Reay, M.D.
• Polina Rebenok
• Mitchell Reber
• Rebong Pediatric Medical Group, P.C.
• Kiana E Rebugio
• Rebuilding Together Silicon Valley
• Marvin Recinos
• Laura-Ashley Recio, PSY
• Michelle Renee Record, MD

• General Practice Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.