MR. KENNY IMAN (P.A.C.) – Specialist, NPI 1295801173

MR. KENNY IMAN (P.A.C.) is a healthcare provider. based in Salisbury, Maryland. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.C.. They hold a License No. C0003072 (MD). The NPI Number for MR. KENNY IMAN (P.A.C.) is 1295801173

Main info

Male
22 Years Of Experience
Accepts Medicare Assignment
Name
MR. KENNY IMAN (P.A.C.)
NPI
1295801173
Phone
(410) 726-1576
Address
4014 OAKLAND SCHOOL RD
Enumeration Date
24 November 2006
Last Update Date
7 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4432102593
Graduation Year
2004 (22 years ago)
PAC ID
1355396466
Group Practice PAC ID
3173897402
Professional Enrollment ID
I20050322000054
Address ID
MD216132506CA300XXHWYX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness75
Years active:19State licenses:2Digital endpointsOther names

3,366 PHYSICIAN ASSISTANT in MD

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Provider Addresses for MR. KENNY IMAN (P.A.C.)

  • 4014 OAKLAND SCHOOL RD

    SALISBURY, MD 218042715

    Phone: (410) 726-1576

    Type: Mailing

  • 111, Davis Street, Canton, Salisbury, Wicomico County, Maryland, 21804, United States

    SALISBURY, MD 218045032

    Phone: (410) 749-4154

    Type: Location

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: 2005-03-22

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
I20050322000054IPhysician AssistantMDTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99203New patient office or other outpatient visit, 30-44 minutes394394$0
99213Established patient office or other outpatient visit, 20-29 minutes355328$0
81003Automated urinalysis test103101$0
87804Detection test by immunoassay with direct visual observation for influenza virus9849$0
87811Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)9593$0
View full utilization report →

Insurance plans in this area (ZIP 21804)

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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: 3173897402View full group profile
NameSpecialtyState
Nurse PractitionerMD
Nurse PractitionerMD
Physician AssistantDE
Nurse PractitionerDE
-MD
Physician AssistantMD
-MD
Nurse PractitionerDE
Nurse PractitionerMD
Physician AssistantMD

Reviews

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Frequently asked questions

How is MR. KENNY IMAN (P.A.C.) identified in CMS data?
CMS-hosted NPPES data lists MR. KENNY IMAN (P.A.C.) with NPI 1295801173.
Is MR. KENNY IMAN (P.A.C.) still practicing?
MR. KENNY IMAN (P.A.C.) is currently listed as active in the public NPI registry.
What taxonomy line describes MR. KENNY IMAN (P.A.C.)?
For research purposes, treat MR. KENNY IMAN (P.A.C.) as Other Service Providers in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect MR. KENNY IMAN (P.A.C.) on a map?
Expect Salisbury, Maryland as a primary anchor for MR. KENNY IMAN (P.A.C.) unless the record lists multiple sites.
Why does MR. KENNY IMAN (P.A.C.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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