Kenneth Adam Poppen, D.O.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

DO2617 Issued in NV

Practice address

6630 S McCarran Blvd Ste B18
Reno, NV 89509-6136

Phone

(775) 237-2833

Fax

(775) 237-2823

NPI assigned

Sep 17, 2012

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA, NV2 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

Specialty

Obstetrics/Gynecology

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Gynecology of Reno PoppenGroup PAC ID 3870976095, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Renown Regional Medical Center Hospital, Reno, NV, CCN 290001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Advanced Gynecology of Reno Poppen

  • Gynecology Physician
  • Reno, NV
  • NPI 1992437057
  Medicare reassignment Care Compare group NPD Authorized official
• Verity Medical Foundation

  • Multi-Specialty Clinic/Center
  • San Jose, CA
  • NPI 1326312067
  Medicare reassignment NPD
• DCHS Medical Foundation

  • Internal Medicine Physician
  • San Jose, CA
  • NPI 1740597368

  Obstetrics & Gynecology

  NPD
• Prime Healthcare Services - Reno LLC

  dba Saint Mary's Regional Medical Center

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1801152566
  NPD (past)
• Renown Regional Medical Center

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1124098421
  NPD (past)
• El Camino Health Medical Group

  • Geriatric Medicine (Family Medicine) Physician
  • Los Gatos, CA
  • NPI 1578831764
  NPD (past)
• O'Connor Hospital

  • Critical Access Hospital
  • Delhi, NY
  • NPI 1801975156
  NPD (past)
• Saint Elizabeths Hospital of Wabasha Inc

  dba Gundersen St. Elizabeth's Hospital and Clinics

  • Skilled Nursing Facility
  • Wabasha, MN
  • NPI 1306864939
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Renown Regional Medical Center

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1124098421
  Care Compare affiliation
• Renown Regional Medical Center

  • General Acute Care Hospital
  • Sparks, NV
  • NPI 1932517299
  Care Compare affiliation

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1730439845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6630 S MCCARRAN BLVD STE B18",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895096136",
            "telephone_number": "775-237-2833",
            "fax_number": "775-237-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6630 S MCCARRAN BLVD STE B18",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895096136",
            "telephone_number": "775-237-2833",
            "fax_number": "775-237-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPPEN",
        "first_name": "KENNETH",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-17",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NV",
            "license": "DO2617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Pope, LCSW
• Kimberly Ann Pope, CRNP
• Samantha Lauren Pope, MSW, LCSW
• Theresa Popiolek
• James A Popovich, CADC
• Lauren Poppen, CRNP
• Adam David Porath, PHARM.D.
• Mary A Porcioncula, MD
• Christine Porras
• Jessica Porreca

• Gynecology Physician in Reno, NV
• Providers in Reno, NV by specialty
• Gynecology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; 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.