Kevin Lowell Kiene, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

7491 Issued in NV

Practice address

640 W Moana LN
Reno, NV 89509-4857

Phone

(775) 324-0699

Fax

(775) 888-8067

NPI assigned

May 24, 2005

Last updated

Jun 28, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Kevin L Kiene Professional name

Medicare fee-for-service enrollment

Enrolled in NV, ID2 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

Dermatology

Education

University of California, Davis School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain West Derm - Blackhart PLLCGroup PAC ID 1153609813, shared by 7 NPIs, 103 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mountain West Derm - Blackhart PLLC

  • MOHS-Micrographic Surgery Physician
  • Reno, NV
  • NPI 1740633015
  Medicare reassignment NPD
• Mountain West Derm-Blackhart, PLLC

  dba Dermatology Clinic of Idaho

  • Dermatology Physician
  • Boise, ID
  • NPI 1548758501
  Medicare reassignment NPD
• Mountain West Derm-Blackhart, PLLC

  • Dermatology Physician
  • Tigard, OR
  • NPI 1316656994
  NPD
• Scdi Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Carson City, NV
  • NPI 1578749917
  NPD (past)
• Dermatology Associates,P.C.

  • Specialist
  • Tigard, OR
  • NPI 1851442461
  NPD (past)
• Mountain West Derm - Blackhart PLLC

  dba Advanced Dermatology & Skin Surgery

  • Dermatology Physician
  • Spokane Valley, WA
  • NPI 1013557933
  NPD (past)
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1881697548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 W MOANA LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895094857",
            "telephone_number": "775-324-0699",
            "fax_number": "775-888-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 W MOANA LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895094857",
            "telephone_number": "775-324-0699",
            "fax_number": "775-888-8067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3640 Warren Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895095240",
            "country_code": "US",
            "telephone_number": "775-324-0699",
            "fax_number": "775-826-8420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIENE",
        "first_name": "KEVIN",
        "middle_name": "LOWELL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NV",
            "license": "7491",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ID",
            "license": "M-15582",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NV",
            "license": "7491",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "ID",
            "license": "M-15582",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2016744",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEVIN",
            "last_name": "KIENE",
            "middle_name": "L",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Crystal Kidwell
• Travis D Kieckbusch, MD
• Cynthie Michelle Kiefer, P.A.
• Breanna Kiehn
• Elizabeth M Kiehn, APRN
• Ashli Nikole Kienenberger-Ruiz, RN
• Dennis Kiesel, P.A.-C
• Janelle Kievit
• Blake Kigerl, NP
• Alma Kiker

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.