DR. JYOTSNA KENI (M.D.) – Pediatric Endocrinology Physician, NPI 1104061407

DR. JYOTSNA KENI (M.D.) is a healthcare provider. based in Fountain valley, California. specializing in PEDIATRIC MEDICINE, ENDOCRINOLOGY. They hold the professional credentials M.D.. They hold a License No. A98869 (CA). The NPI Number for DR. JYOTSNA KENI (M.D.) is 1104061407

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
DR. JYOTSNA KENI (M.D.)
NPI
1104061407
Phone
(714) 432-1950
Address
11160 WARNER AVE
Enumeration Date
16 December 2008
Last Update Date
7 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9497609222
Graduation Year
2003 (23 years ago)
PAC ID
4789864141
Group Practice PAC ID
9537345665
Professional Enrollment ID
I20110202000601
Address ID
CA921098737SA4490XSTXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:17State licenses:1Digital endpointsOther names

2,386 PEDIATRIC MEDICINE in CA

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Provider Addresses for DR. JYOTSNA KENI (M.D.)

  • 11160, Warner Avenue, Fountain Valley, Orange County, California, 92708, United States

    SUITE 117

    FOUNTAIN VALLEY, CA 927084008

    Phone: (714) 432-1950

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-02-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110202000601IPediatric MedicineCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92708)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537345665View full group profile
NameSpecialtyState
Family PracticeCA
Physical Therapist In Private PracticeCA
-CA
Family PracticeCA
-CA
Emergency MedicineCA
General PracticeCA
Family PracticeCA
Physician AssistantCA
-MA

Reviews

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Frequently asked questions

Can I cross-check DR. JYOTSNA KENI (M.D.) using NPI 1104061407?
NPI 1104061407 belongs to DR. JYOTSNA KENI (M.D.); compare other details if you need extra assurance.
Active or inactive — what applies to DR. JYOTSNA KENI (M.D.)?
You should see DR. JYOTSNA KENI (M.D.) as active in CMS-hosted NPPES data.
What clinical focus is listed for DR. JYOTSNA KENI (M.D.)?
At a glance, DR. JYOTSNA KENI (M.D.) is tied to Pediatric Endocrinology Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with DR. JYOTSNA KENI (M.D.)?
Directory geography for DR. JYOTSNA KENI (M.D.) centers on Fountain Valley, California.
When was this NPI issued?
Enumeration for DR. JYOTSNA KENI (M.D.) is noted as December 16, 2008 where the registry provides it.

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