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KENNETH GWINN MD
NPI 1003910118
Otolaryngology - Otolaryngology/Facial Plastic Surgery in Shelby Township, MI

Active since September 11, 2006PECOS EnrolledAccepts Medicare Assignment
81.97/100
CMS Quality Rating
48681 HAYES RD, SHELBY TOWNSHIP, MI 48315(586) 799-1212(586) 799-1210 Get Directions Write a Review

NPPES record last updated: December 22, 2011. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Kenneth Gwinn Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH GWINN MD (NPI 1003910118) is an individual otolaryngology/facial plastic surgery provider in Shelby Township, Michigan, licensed in Michigan (KG050974) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Henry Ford Macomb Hospital, and is a graduate of Illinois Medical College (1985).

NPPES Registry Identity

NPI1003910118
Entity TypeIndividualMale
Primary Taxonomy207YX0905X
Provider Legal NameKENNETH GWINNCredential: MD
Location Address48681 HAYES RDShelby Township, MI 48315-4403
Mailing Address48681 Hayes RdShelby Township, MI 48315-4403 · (586) 799-1212 · Fax (586) 799-1210
Phone(586) 799-1212
Fax(586) 799-1210
Sole ProprietorNo
Medical School CMSIllinois Medical CollegeGraduated 1985
Enumeration DateSeptember 11, 2006
Last NPPES UpdateDecember 22, 2011
✔ NPI 1003910118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Otolaryngology/Facial Plastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207YX0905X
License✔ Licensed in MI · KG050974
Definition
An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.
48681 HAYES RD, Shelby Township, MI 48315
Open in Google Maps ↗

Other Identifiers 7

Other000000009639MI · Cape Health
Medicare UPINE95575
Other131442MI · Preferred Choices
Other0405011981MI · Bcbs
Medicare ID-Type Unspecified0P08960001MI
OtherC7134MI · Mcare Hmo
Other258611MI · Omnicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kenneth Gwinn Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3577513944
PECOS Enrollment IDI20050126000238
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kenneth Gwinn reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kenneth L Gwinn MD PC
Same address
Otolaryngology/Facial Plastic Surgery
48681 HAYES RD
Shelby Township, MI 48315
  • Reassigned Medicare billing, Michigan enrollment
  • 9 clinicians in this Medicare group
NPI 1629163217 (586) 799-1212

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
552 services315 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
429 services247 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
265 services189 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
254 services148 patients
Test to assess middle ear function 92567
A test to assess middle ear function, also known as an impedance audiometry, helps evaluate how well your middle ear works. It measures the movement of your eardrum in response to changes in air pressure. This can help identify issues like fluid build-up, ear infections, or eardrum perforations.
124 services89 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
84 services84 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Henry Ford Macomb Hospital

Acute Care Hospitals · Clinton Township, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230047
Location15855 Nineteen Mile RdClinton Township, MI 48038 · Macomb County
Emergency services Birthing friendly

Beaumont Hospital - Grosse Pointe

Acute Care Hospitals · Grosse Pointe, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230089
Location468 Cadieux RdGrosse Pointe, MI 48230 · Wayne County
Emergency services Birthing friendly

Beaumont Hospital Royal Oak

Acute Care Hospitals · Royal Oak, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230130
Location3601 W Thirteen Mile RdRoyal Oak, MI 48073 · Oakland County
Emergency services Birthing friendly

Ascension St John Hospital

Acute Care Hospitals · Detroit, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230165
Location22101 Moross RdDetroit, MI 48236 · Wayne County
Emergency services Birthing friendly

Beaumont Hospital, Troy

Acute Care Hospitals · Troy, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230269
Location44201 Dequindre RoadTroy, MI 48085 · Oakland County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.97/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality75.95
Promoting Interoperability84
Improvement Activities40

Reported Quality Measures

Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy - Avoidance of Inappropriate Use
89%133 patients
Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse)
Lower rates are better for this measure.
0%89 patients5/55-star benchmark: 100%
Advance Care Plan
30%1,083 patients2/55-star benchmark: 100%
Controlling High Blood Pressure
74%854 patients4/55-star benchmark: 98%
Documentation of Current Medications in the Medical Record
2%4,685 patients1/55-star benchmark: 100%
One-Time Screening for Hepatitis C Virus (HCV) for all Patients
0%1,485 patients1/55-star benchmark: 98%
Overuse of Imaging for the Evaluation of Primary Headache
Lower rates are better for this measure.
0%241 patients
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
22%2,422 patients1/55-star benchmark: 100%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
9%3,496 patients1/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 38% · 1,300 patients
Patients screened: 42% · 1,300 patients
9%55 patients1/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Patients combinedPopulations: 46% · 1,263 patients
Patients screened: 61% · 1,263 patients
0%191 patients
Provide Patients Electronic Access to Their Health Information
79%2,611 patients3/55-star benchmark: 100%
Tobacco Use and Help with Quitting Among Adolescents
63%87 patients1/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. CATHERINE LYNN GAVAN PA-C
Physician Assistant
48681 HAYES RD, SUITE 200
SHELBY TOWNSHIP, MI 48315
Macomb County (586) 799-1212
DR. DONALD C. GALOVICH D.C.
Chiropractor
48681 HAYES RD
SHELBY TWP, MI 48315
Macomb County (586) 726-7777
KENNETH L GWINN MD PC
Otolaryngology (Otolaryngology/Facial Plastic Surgery)
48681 HAYES RD
SHELBY TOWNSHIP, MI 48315
Macomb County (586) 799-1212
MRS. AMANDA CELESTE M.S, CCC-SLP
Speech-Language Pathologist
48681 HAYES RD
SHELBY TWP, MI 48315
Macomb County (588) 726-7777
AMANDA A THOMAS
Physician Assistant
48681 HAYES RD
SHELBY TWP, MI 48315
Macomb County (586) 799-1212

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Gwinn's NPI number?

The NPI number for Kenneth Gwinn is 1003910118. It was assigned to this individual provider in the NPPES registry on September 11, 2006.

Where is Kenneth Gwinn located?

Kenneth Gwinn practices at 48681 Hayes Rd, Shelby Township, MI 48315. The listed phone number is (586) 799-1212.

What is Kenneth Gwinn's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Otolaryngology/Facial Plastic Surgery, with taxonomy code 207YX0905X.

Is Kenneth Gwinn enrolled in Medicare?

Yes. Kenneth Gwinn is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kenneth Gwinn's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Gwinn reassigns Medicare benefits to Kenneth L Gwinn MD PC (Shelby Township, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kenneth Gwinn's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kenneth Gwinn accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and UnitedHealthcare list Kenneth Gwinn as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kenneth Gwinn affiliated with any hospitals?

According to CMS data, Kenneth Gwinn is affiliated with Henry Ford Macomb Hospital, Beaumont Hospital - Grosse Pointe, Beaumont Hospital Royal Oak, Ascension St John Hospital and Beaumont Hospital, Troy.

When was this NPI record last updated?

The NPPES record for Kenneth Gwinn was last updated on December 22, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.