Individual provider Active NPI

Kelli Kaneta, MD

  • Pediatric Nephrology Physician
  • Aurora, CO
National Provider Identifier
1679133789
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
DR.0078136 Issued in CO
Practice address
13123 E 16TH Ave
Aurora, CO 80045-7106
Phone
(720) 777-1234
NPI assigned
Jun 20, 2019
Last updated
Oct 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DR.0078136 CO
Pediatrics Physician 208000000X A176966 CA
Pediatric Nephrology Physician 2080P0210X DR.0078136 CO Primary

Addresses

Primary practice location

13123 E 16TH Ave
Aurora, CO 80045-7106

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, HI2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20230720003128 CA Practitioner - Pediatric Medicine 0941660021 Reassigns benefits to 1 organization
I20260323002171 HI Practitioner - Pediatric Medicine 0941660021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Hospital Los Angeles Medical Group IncGroup PAC ID 0143126920, 288 clinicians

Practice addresses (Care Compare)

4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone (323) 361-8408

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A176966CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Jul 6, 2023 Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients
Children's Hospital Los Angeles Past Accepting new patients

Locations

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

4650 W Sunset Blvd
#87
Los Angeles, CA 90027

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1679133789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANETA",
        "first_name": "KELLI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0078136",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A176966",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "CO",
            "license": "DR.0078136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.