Kenneth J Washenik, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

213038 Issued in MA

Practice address

9100 Wilshire Blvd
East Tower Penthouse
Beverly Hills, CA 90212-3401

Phone

(310) 288-9999

NPI assigned

Feb 15, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bosley Medical Group, P.C.

  • Dermatology Physician
  • Boston, MA
  • NPI 1710322854
  NPD (past) Authorized official

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487797940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 WILSHIRE BLVD",
            "address_2": "EAST TOWER PENTHOUSE",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123401",
            "telephone_number": "310-288-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 WILSHIRE BLVD",
            "address_2": "EAST TOWER PENTHOUSE",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123401",
            "telephone_number": "310-288-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHENIK",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "213038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Shih-Yuh Wang, B.S., MS-DPT
• Omeed Warej, M.D.
• Kelly Danae Warner, LCSW
• Warren L. Roston MD - a Professional Corporation
• Warren M. Lent MD Inc
• Leslie Washington
• Theressia Louise Washington, M.D., M.S., FAAFP
• Mina Wasif, PHARMD
• Michael Haley Waterhouse, L.AC.
• Yana A Waters

• Dermatology Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.