Individual provider Active NPI

David J Kiener, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Roseville, CA
National Provider Identifier
1770605495
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
G29773 Issued in CA
Practice address
5 Medical Plaza Dr Ste 100
Roseville, CA 95661-2866
Phone
(916) 773-0395
Fax
(916) 736-6638
NPI assigned
Apr 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X G29773 CA Primary

Addresses

Primary practice location

5 Medical Plaza Dr Ste 100
Roseville, CA 95661-2866

Mailing address

1111 Exposition Blvd BLDG 700
Sacramento, CA 95815-4314
Phone (916) 736-3399

Other identifiers 1

IdentifierTypeStateIssuer
0400011479OtherCARR MEDICARE PIN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20061018000625 CA Practitioner - OtolaryngologyPractitioner - Physical Medicine and RehabilitationPractitioner - Plastic and Reconstructive Surgery 0446256218 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Medical College of Wisconsin, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2 Medical Plaza Dr
Suite 225
Roseville, CA 95661-3044
Phone (916) 782-1291

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.25 of 100Reported as group
Quality
51.19
Promoting interoperability
94
Improvement activities
40
Cost
61.73

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G29773CAMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Apr 1, 2014 Accepting new patients
Sacramento Ear Nose & Throat Surgical & Medical Group Inc Otolaryngology/Facial Plastic Surgery CurrentSince Sep 25, 2007 Accepting new patients
Emergency and Acute Care Medical Corporation PastSince Jan 14, 2024 Accepting new patients

Locations

5 Medical Plaza Dr
Ste 100
Roseville, CA 95661
Phone (916) 773-0385

2 Medical Plaza Dr
Ste 225
Roseville, CA 95661
Phone (916) 782-1291

2 Medical Plaza Dr
Ste 235
Roseville, CA 95661
Phone (916) 782-1086

1111 Exposition Blvd
Ste 700
Sacramento, CA 95815
Phone (916) 736-3399

1111 Exposition Blvd
Bldg 700
Sacramento, CA 95815
Phone (916) 736-3399

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

Interoperability endpoints

  • Direct secure messaging: dkiener34732@hisp.ehr.sutterhealth.org

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 and National Provider Directory roles.

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1770605495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 EXPOSITION BLVD BLDG 700",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154314",
            "telephone_number": "916-736-3399",
            "fax_number": "916-233-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEDICAL PLAZA DR STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612866",
            "telephone_number": "916-773-0395",
            "fax_number": "916-736-6638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIENER",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "CA",
            "license": "G29773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "0400011479",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.