Individual provider Active NPI

Kenneth Kist, MD

  • Diagnostic Radiology Physician
  • San Antonio, TX
National Provider Identifier
1720195894
Registry record updated May 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
J4268 Issued in TX
Practice address
7703 Floyd Curl Dr
MC 7977
San Antonio, TX 78229-3901
Phone
(210) 257-1400
Fax
(210) 257-1428
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X J4268 TX Primary

Addresses

Primary practice location

7703 Floyd Curl Dr
MC 7977
San Antonio, TX 78229-3901

Mailing address

7703 Floyd Curl Dr
MC 7977
San Antonio, TX 78229-3901
Phone (210) 257-1400

Other identifiers 3

IdentifierTypeStateIssuer
129729307OtherTXCSHCN
129729304MedicaidTX
129729306MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20061122000278 TX Practitioner - Diagnostic Radiology 0244238418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Hahnemann University College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Texas Health Science Center at San AntonioGroup PAC ID 0042128548, 1,290 clinicians

Practice addresses (Care Compare)

8300 Floyd Curl Dr
San Antonio, TX 78229-3931
Phone (210) 450-9000

Hospital & facility affiliations

  • University Health System Hospital, San Antonio, TX, CCN 450213
  • Ut Health San Antonio Multispecialty & Research Ho Hospital, San Antonio, TX, CCN 670335

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Health Science Center at San Antonio Diagnostic Radiology CurrentSince Apr 20, 2009 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Apr 20, 2009 Accepting new patients
University of Texas Health Science Center at San Antonio Diagnostic Radiology Current Accepting new patients

Locations

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

8300 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-9300

7979 Wurzbach Rd
San Antonio, TX 78229
Phone (210) 450-1000

2121 SW 36th St
San Antonio, TX 78237
Phone (210) 358-5100

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

7703 Floyd Curl Dr
#7977
San Antonio, TX 78229
Phone (210) 292-0400

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241568000000",
    "number": "1720195894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "address_2": "MC 7977",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901",
            "telephone_number": "210-257-1400",
            "fax_number": "210-257-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "address_2": "MC 7977",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901",
            "telephone_number": "210-257-1400",
            "fax_number": "210-257-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIST",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2009-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "J4268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "129729307",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129729304",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129729306",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.