Individual provider Active NPI

Michael D. Kenner, M.D.

  • Cardiovascular Disease Physician
  • Aurora, CO
National Provider Identifier
1417912460
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
52174 Issued in CO
Practice address
1444 S Potomac St
Aurora, CO 80012-4508
Phone
(303) 750-0822
Fax
(303) 750-1298
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD174464 OR
Cardiovascular Disease Physician 207RC0000X 52174 CO Primary
Cardiovascular Disease Physician 207RC0000X M7936 ID

Addresses

Primary practice location

1444 S Potomac St
Aurora, CO 80012-4508

Mailing address

4900 S Monaco St
#210
Denver, CO 80237-3486
Phone (303) 750-0822

Other practice location 1

940 Central Park Dr Ste 202
Steamboat Springs, CO 80487-8853
Phone (970) 870-1035

Other practice location 2

777 Bannock St
Denver, CO 80204-4597
Phone (303) 436-4949

Other practice location 3

10000 SE Main St Ste 60
Portland, OR 97216-2461
Phone (503) 257-0959

Other identifiers 2

IdentifierTypeStateIssuer
54426065MedicaidCO
805657700MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, CO, OR, TN, AL, TX, WA7 enrollments
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 7

Enrollment IDStateProvider typePAC IDDetails
I20120627000280 AK Practitioner - Cardiovascular Disease (Cardiology) 4082632849 Reassigns benefits to 1 organization
I20130815000870 CO Practitioner - Cardiovascular Disease (Cardiology) 4082632849 Reassigns benefits to 4 organizations
I20160502002000 OR Practitioner - Cardiovascular Disease (Cardiology) 4082632849 Reassigns benefits to 2 organizations
I20230802004169 TN Practitioner - Internal MedicinePractitioner - Nuclear Medicine 4082632849 Reassigns benefits to 1 organization
I20230803001266 AL Practitioner - Internal MedicinePractitioner - Nuclear Medicine 4082632849 Reassigns benefits to 1 organization
I20230914001037 TX Practitioner - Internal MedicinePractitioner - Nuclear Medicine 4082632849 Reassigns benefits to 1 organization
I20240821003738 WA Practitioner - Cardiovascular Disease (Cardiology) 4082632849 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Maryland School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairbanks Memorial Cardiology Center LLCGroup PAC ID 0244511269, 25 clinicians
Denver Health and Hospital AuthorityGroup PAC ID 4688583578, shared by 20 NPIs, 830 clinicians

Practice addresses (Care Compare)

1650 Cowles St
Fairbanks, AK 99701-5907
Phone (907) 458-6450

777 Bannock St
Denver, CO 80204-4507
Phone (303) 436-6000

777 Bannock St
Denver, CO 80204-4597

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52174COMDCardiovascular Disease Physician
M7936IDMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Cardiovascular Disease Current Accepting new patients
Public Hospital District No. 2, Klickitat County, Washington Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jan 21, 2019 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jul 20, 2020 Accepting new patients
Yampa Valley Medical Center Current Accepting new patients
Public Hospital District No 2, Klickitat County, Washington CurrentSince Sep 1, 2024 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jan 21, 2019 Accepting new patients
Healthcare for the Mid-Columbia Region Current Accepting new patients
Mid-Columbia Medical Center CurrentSince Jan 1, 2024 Accepting new patients
Bay Area Hospital District CurrentSince Jan 26, 2016 Accepting new patients
Denver Health and Hospital Authority CurrentSince Sep 22, 2016 Accepting new patients
Yampa Valley Medical Center CurrentSince Mar 25, 2020 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jul 20, 2020 Accepting new patients
Nuvoair Medical PC CurrentSince Aug 1, 2023 Accepting new patients
Denver Health and Hospital Authority CurrentSince Sep 22, 2016 Accepting new patients
Fairbanks Memorial Cardiology Center, LLC CurrentSince Jul 19, 2024 Accepting new patients
Public Hospital District No 2, Klickitat County Washington CurrentSince Sep 1, 2024 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Cardiovascular Disease Current Accepting new patients
Mid-Columbia Medical Center CurrentSince Jan 1, 2024 Accepting new patients
Bay Area Hospital District CurrentSince Jan 26, 2016 Accepting new patients
Saint Alphonsus Medical Center Nampa, Inc. Past Accepting new patients
Yampa Valley Medical Center Past Accepting new patients
Boise Valley Asthma & Allergy PA Past Accepting new patients
Gooding County Hospital District Past Accepting new patients
Fairbanks Memorial Cardiology Center Cardiovascular Disease Past Accepting new patients
Denver Health and Hospital Authority Past Accepting new patients
North Phoenix Heart Center Cardiovascular Disease Past Accepting new patients
Saint Alphonsus Regional Medical Center Inc Cardiovascular Disease Past Accepting new patients
Saint Alphonsus Regional Medical Center Inc Past Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients

Locations

1650 Cowles St
Fairbanks, AK 99701
Phone (907) 452-8181

1650 Cowles St
#60A
Fairbanks, AK 99701
Phone (907) 458-5525

Dept LA 25339
Pasadena, CA 91185

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

777 Bannock St
Denver, CO 80204

777 Bannock St
Ste MC3450
Denver, CO 80204

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

940 Central Park Dr
Ste 202
Steamboat Springs, CO 80487
Phone (970) 870-1035

1024 Central Park Dr
Steamboat Springs, CO 80487
Phone (970) 824-1322

1100 Central Park Dr
Ste 1050
Steamboat Springs, CO 80487
Phone (970) 870-1035

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

50 Milk St
Boston, MA 02109

50 Milk St
Fl 16
Boston, MA 02109
Phone (617) 213-0335

1775 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-8090

2650 N 17th St
Coos Bay, OR 97420
Phone (541) 267-5411

1805 E 19th St
The Dalles, OR 97058
Phone (541) 296-2201

551 Lone Pine Blvd
The Dalles, OR 97058
Phone (541) 296-7202

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

1341 W Mockingbird Ln
Ste 600W
Dallas, TX 75247
Phone (303) 748-5781

Interoperability endpoints

  • Direct secure messaging: mkenner72544@direct.dhha.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/ac6e817f-dc27-43e8-b886-6559f137e853/
  • Direct secure messaging: michael.kenner.p1@direct.porterheart.nextgenshare.com
  • Direct secure messaging: mkenner154556@direct.ohsu.edu

Organizations & group practices 31

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.

View all 31

Hospital & facility affiliations 4

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1417912460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 S MONACO ST",
            "address_2": "#210",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802373486",
            "telephone_number": "303-750-0822",
            "fax_number": "303-750-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1444 S POTOMAC ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800124508",
            "telephone_number": "303-750-0822",
            "fax_number": "303-750-1298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "940 Central Park Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Steamboat Springs",
            "state": "CO",
            "postal_code": "804878853",
            "country_code": "US",
            "telephone_number": "970-870-1035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "777 Bannock St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802044597",
            "country_code": "US",
            "telephone_number": "303-436-4949",
            "fax_number": "303-602-3902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10000 SE Main St Ste 60",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972162461",
            "country_code": "US",
            "telephone_number": "503-257-0959",
            "fax_number": "503-256-7757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNER",
        "first_name": "MICHAEL",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD174464",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "52174",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ID",
            "license": "M7936",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54426065",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805657700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.