KENNETH IAN LIGHT M.D.
NPI 1104900919
Specialist in San Francisco, CA
About Kenneth Ian Light M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENNETH IAN LIGHT M.D. (NPI 1104900919) is an individual specialist in San Francisco, California, licensed in (G35263) and active in the NPI registry since October 2006. He has opted out of Medicare through July 1, 2027.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Kenneth Ian Light M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2023 through July 1, 2027.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN FRANCISCO, CA 94109
SAN FRANCISCO, CA 94109
SAN FRANCISCO, CA 94109
SAN FRANCISCO, CA 94109
SAN FRANCISCO, CA 94109
SAN FRANCISCO, CA 94109
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 Light's NPI number?
The NPI number for Kenneth Light is 1104900919. It was assigned to this individual provider in the NPPES registry on October 25, 2006.
Where is Kenneth Light located?
Kenneth Light practices at 1700 California St Suite 340, San Francisco, CA 94109. The listed phone number is (415) 673-4500.
What is Kenneth Light's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Kenneth Light enrolled in Medicare?
No. Kenneth Light has opted out of Medicare through July 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Kenneth Light was last updated on July 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Kenneth Ian Light, M.D. · NPI 1104900919
Specialist provider in San Francisco, California. Individual provider, active in the CMS NPPES registry since October 25, 2006.
## Identity
- **NPI:** 1104900919 (Entity type: Individual)
- **Enumerated:** October 25, 2006
- **Primary specialty:** Specialist · taxonomy 174400000X
- **State license:** G35263
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1700 CALIFORNIA ST, SUITE 340, San Francisco, CA 94109-4586
- **Phone:** (415) 673-4500
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through July 1, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** July 19, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1104900919) · Data from the CMS NPPES public registry.