DR. KENNETH MICHAEL DOWNES MD
NPI 1215226014
Ophthalmology in Albuquerque, NM

Active since April 01, 2011PECOS EnrolledAccepts Medicare Assignment
87.88/100
CMS Quality Rating
7110 WYOMING BLVD NE, ALBUQUERQUE, NM 87109(505) 346-0500(505) 346-0164 Get Directions Write a Review

NPPES record last updated: July 19, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 19, 2024, Jul 13, 2023, Jan 24, 2022 and 3 more (6 updates tracked since 2016).

About Dr. Kenneth Michael Downes Md NPPES

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

DR. KENNETH MICHAEL DOWNES MD (NPI 1215226014) is an individual ophthalmology provider in Albuquerque, New Mexico, licensed in New Mexico (MD2017-0187) and active in the NPI registry since April 2011. He is enrolled in Medicare PECOS, is affiliated with Unm Hospital, and is a graduate of University Of New Mexico School Of Medicine (2011).

NPPES Registry Identity

NPI1215226014
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. KENNETH MICHAEL DOWNESCredential: MD
Location Address7110 WYOMING BLVD NEAlbuquerque, NM 87109-4867
Mailing Address3375 Sw Terwilliger BlvdPortland, OR 97239-4146 · (503) 494-3929
Fax(505) 346-0164
Sole ProprietorNo
Medical School CMSUniversity Of New Mexico School Of MedicineGraduated 2011
Enumeration DateApril 1, 2011
Last NPPES UpdateJuly 19, 20246 updates tracked since enumeration
NPPES CertifiedJuly 19, 2024
NPI 1215226014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses Licensed in NM · MD2017-0187 Licensed in CA · A123717 Licensed in OR · MD176549
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
7110 WYOMING BLVD NE, Albuquerque, NM 87109

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Kenneth Michael Downes 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 ID5799089439
PECOS Enrollment IDI20170724001850
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.

Areas of Expertise CMS Part B claims 17

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.

Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
786 services741 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
488 services483 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.
457 services335 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
195 services97 patients
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.
173 services160 patients
Removal of recurring cataract in lens capsule using a laser 66821
This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.
163 services113 patients

Hospital Affiliations CMS Care Compare

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

Unm Hospital

Acute Care Hospitals · Albuquerque, NM
2/5 CMS rating
OwnershipGovernment - State
CMS Certification Number320001
Location2211 Lomas Boulevard NEAlbuquerque, NM 87106 · Bernalillo County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87109 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.21 typical visit price
range $54.26 – $166.80
Typical copayment $31.55 (range $13.56 – $41.70)
Most-billed visit code 99204
Established Patient
$68.00 typical visit price
range $17.00 – $135.35
Typical copayment $17.00 (range $4.25 – $33.83)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

87.88/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost59.6

Other Providers at the Same Location NPPES 9

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

Ophthalmology
7110 WYOMING BLVD NE
ALBUQUERQUE, NM 87109
Eyewear Supplier
7110 WYOMING BLVD NE
ALBUQUERQUE, NM 87109
Ophthalmology
7110 WYOMING BLVD NE
ALBUQUERQUE, NM 87109
Optometrist
7110 WYOMING BLVD NE
ALBUQUERQUE, NM 87109
Ophthalmology
7110 WYOMING BLVD NE
ALBUQUERQUE, NM 87109
Ophthalmology
7110 WYOMING BLVD NE
ALBUQUERQUE, NM 87109
Ophthalmology
7110 WYOMING BLVD NE
ALBUQUERQUE, NM 87109
Ophthalmology
7110 WYOMING BLVD NE
ALBUQUERQUE, NM 87109

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 Downes's NPI number?

The NPI number for Kenneth Downes is 1215226014. It was assigned to this individual provider in the NPPES registry on April 1, 2011.

Where is Kenneth Downes located?

Kenneth Downes practices at 7110 Wyoming Blvd NE, Albuquerque, NM 87109. The listed phone number is (505) 346-0500.

What is Kenneth Downes's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Kenneth Downes enrolled in Medicare?

Yes. Kenneth Downes 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.

What insurance does Kenneth Downes accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list Kenneth Downes 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 Downes affiliated with any hospitals?

According to CMS data, Kenneth Downes is affiliated with Unm Hospital.

When was this NPI record last updated?

The NPPES record for Kenneth Downes was last updated on July 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.