Individual provider Active NPI

Kenneth Allen Podlenski, AU.D.

  • Audiologist-Hearing Aid Fitter
  • San Diego, CA
National Provider Identifier
1366604803
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
AU2607 Issued in CA
Practice address
12396 World Trade Dr
Suite 205
San Diego, CA 92128-3786
Phone
(858) 674-1910
NPI assigned
Jun 26, 2008
Last updated
Aug 22, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X AU2607 CA Primary

Addresses

Primary practice location

12396 World Trade Dr
Suite 205
San Diego, CA 92128-3786

Mailing address

12396 World Trade Dr
Suite 205
San Diego, CA 92128-3786
Phone (858) 674-1910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AU2607CAMDAudiologist-Hearing Aid Fitter

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1366604803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12396 WORLD TRADE DR",
            "address_2": "SUITE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283786",
            "telephone_number": "858-674-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12396 WORLD TRADE DR",
            "address_2": "SUITE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283786",
            "telephone_number": "858-674-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODLENSKI",
        "first_name": "KENNETH",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "AU2607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; 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.