Individual provider Active NPI

Kevin K Kane, M.D.

  • Anesthesiology Physician
  • Waukesha, WI
National Provider Identifier
1922082122
Registry record updated Feb 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
38241-020 Issued in WI
Practice address
725 American Ave
Waukesha, WI 53188-5031
Phone
(262) 544-2011
NPI assigned
Dec 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 38241-020 WI Primary

Addresses

Primary practice location

725 American Ave
Waukesha, WI 53188-5031

Mailing address

225 S Executive Dr
Brookfield, WI 53005-4266
Phone (262) 787-4026

Other identifiers 2

IdentifierTypeStateIssuer
050058389OtherRAIL ROAD MEDICARE
32354600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20110211000747 WI Practitioner - Anesthesiology 9234025321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical College of Wisconsin, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ketamine Milwaukee SCGroup PAC ID 5799212288, 4 clinicians
Anex, S.C.Group PAC ID 4486540556, 38 clinicians

Practice addresses (Care Compare)

10424 W Bluemound Rd
Milwaukee, WI 53226-4331
Phone (414) 206-1606

725 S American Ave
Waukesha, WI 53188-5301
Phone (262) 544-2011

Hospital & facility affiliations

  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
  • Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043
  • Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38241-020WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sana Medical SC Anesthesiology Current Accepting new patients
Anex, S.C. Anesthesiology CurrentSince Sep 1, 1997 Accepting new patients
Ketamine Milwaukee, SC Anesthesiology CurrentSince Nov 18, 2024 Accepting new patients

Locations

225 S Executive Dr
Brookfield, WI 53005
Phone (262) 787-4026

1001 W Glen Oaks Ln
Ste 105
Mequon, WI 53092
Phone (414) 258-8314

Bin 88836
Milwaukee, WI 53288

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

10424 W Bluemound Rd
Wauwatosa, WI 53226
Phone (414) 206-1606

Interoperability endpoints

  • Direct secure messaging: kkane4171@direct.phci.org

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 4

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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234656000000",
    "number": "1922082122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S EXECUTIVE DR",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054266",
            "telephone_number": "262-787-4026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 AMERICAN AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885031",
            "telephone_number": "262-544-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "KEVIN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2009-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "38241-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "050058389",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32354600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.