Jack D Kennis, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G46843 Issued in CA

Practice address

11500 Brookshire Ave
Downey, CA 90241

Phone

(562) 904-5000

NPI assigned

May 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Internal MedicineAlso: Emergency Medicine

Education

Irvine California College of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sarah Sandell MD Facp and Susan Sleep MD AMCGroup PAC ID 9234470535, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sarah Sandell MD Facp & Susan Sleep MD AMC

  • Specialist
  • Los Alamitos, CA
  • NPI 1316241003
  Medicare reassignment Care Compare group NPD
• Jack Kennis MD Inc

  • Internal Medicine Physician
  • Yorba Linda, CA
  • NPI 1033922497
  NPD Authorized official

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1477504249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39159",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "90239",
            "telephone_number": "562-809-3576",
            "fax_number": "562-468-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 BROOKSHIRE AVE",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "90241",
            "telephone_number": "562-904-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNIS",
        "first_name": "JACK",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G46843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G468430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Kela, NATUROPATHIC DOCTOR
• Janet Keller, M.D.
• Daniel E Kelly
• Ariana Kennedy
• Kenneth N. Ferraro, D.D.S., Inc
• Michael Hoang Kenny, MD
• Preston I. Kent, MA, PT
• Jeffrey Fuqua Kerbel, PT, DPT
• Lisa Kerestedjian, M.D.
• Ankit J Keshav, DDS

• Emergency Medicine Physician in Downey, CA
• Providers in Downey, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.