Look up the most recent NPI and PECOS records

Kenneth F Colina

Pediatrics

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as KENNETH COLINA.

Based on the most recent information from CMS, provider Kenneth F Colina is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 2:29 PM.

Profile Details

Provider ID
1538273008
Provider Type
Individual
Full Name
Colina, Kenneth F
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
8/19/2006
Last Updated
5/30/2018

Contact Information

Practice Location

3020 Childrens Way, San Diego, CA 92123

(858) 966-5841

Unlisted Fax

Mailing Location

3020 Childrens Way # Mc5064, San Diego, CA 92123-4223

(858) 966-5841

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208000000X Primary	Description Pediatrics Allopathic & Osteopathic Physicians	License 153469 California
Code 208000000X	Description Pediatrics Allopathic & Osteopathic Physicians	License J3298 Texas
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License J3298 Texas

Provider Identifiers

ID	Description	Issuer
ID 110625102	Description Other	Issuer FIRSTCARE PIN Texas
ID 125007806	Description Medicaid	Issuer Unlisted Texas
ID 140442852	Description Medicaid	Issuer Unlisted Texas
ID 1218867	Description Other	Issuer FIRSTHEALTH PIN Texas
ID 124106	Description Other	Issuer SUPERIOR PIN Texas
ID 88705G	Description Other	Issuer BCBSTX IND PIN Texas
ID 00U87Z	Description Other	Issuer BCBSTX GRP PIN Texas
ID 1750369203	Description Other	Issuer GRP NPI NUMBER
ID 2352398	Description Other	Issuer UHC PIN Texas
ID 4536787	Description Other	Issuer AETNA PIN Texas
ID 7097804	Description Other	Issuer CIGNA PIN Texas
ID 137345810	Description Medicaid	Issuer Unlisted Texas
ID 10011558	Description Other	Issuer AMERIGROUP PIN Texas
ID 125007805	Description Medicaid	Issuer Unlisted Texas

Kenneth F Colina

PECOS Enrollment

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