KENNETH KIN NING POON FNP-C
NPI 1790222164
Nurse Practitioner - Family in San Carlos, CA
About Kenneth Kin Ning Poon Fnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENNETH KIN NING POON FNP-C (NPI 1790222164) is an individual family provider in San Carlos, California, licensed in California (95005757) and active in the NPI registry since January 2017. He is enrolled in Medicare PECOS, maintains a secondary practice location in Fremont, and is a graduate of Other (2016).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
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 Kin Ning Poon Fnp-c 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.
Medicare Billing Reassignment
Medicare enrollment records show Kenneth Poon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Palo Alto, CA 94301
- Reassigned Medicare billing, California enrollment
- 4,479 clinicians in this Medicare group
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 4
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 94070 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 CARLOS, CA 94070
SAN CARLOS, CA 94070
SAN CARLOS, CA 94070
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 Poon's NPI number?
The NPI number for Kenneth Poon is 1790222164. It was assigned to this individual provider in the NPPES registry on January 24, 2017.
Where is Kenneth Poon located?
Kenneth Poon practices at 301 Industrial Rd, San Carlos, CA 94070. The listed phone number is (650) 596-4000.
What is Kenneth Poon's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kenneth Poon enrolled in Medicare?
Yes. Kenneth Poon 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 Poon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Poon reassigns Medicare benefits to Sutter Bay Medical Foundation (Palo Alto, CA). 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 Poon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kenneth Poon was last updated on June 12, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 Kin Ning Poon, FNP-C · NPI 1790222164
Family physician in San Carlos, California. Individual provider, active in the CMS NPPES registry since January 24, 2017.
## Identity
- **NPI:** 1790222164 (Entity type: Individual)
- **Enumerated:** January 24, 2017
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95005757 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 301 INDUSTRIAL RD, San Carlos, CA 94070-2603
- **Phone:** (650) 596-4000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Sutter Bay Medical Foundation (NPI 1013950807, Palo Alto, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** June 12, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1790222164) · Data from the CMS NPPES public registry.