Kenndal Soto, AGACNP-BC - Medicare Nurse Practitioner in Detroit, MI

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Kenndal Soto, AGACNP-BC is a medicare enrolled "Nurse Practitioner - Acute Care" in Detroit, Michigan. Her current practice location is 2799 W Grand Blvd, Detroit, Michigan. You can reach out to her office (for appointments etc.) via phone at (800) 653-6568.

Kenndal Soto is licensed to practice in Michigan (license number 4704299368) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1093317133.

Contact Information

Kenndal Soto, AGACNP-BC
2799 W Grand Blvd,
Detroit, MI 48202-2608
(800) 653-6568
(313) 876-1305

Map and Direction




Provider's Profile

Full NameKenndal Soto
GenderFemale
SpecialityNurse Practitioner - Acute Care
Location2799 W Grand Blvd, Detroit, Michigan
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1093317133
  • Provider Enumeration Date: 11/13/2020
  • Last Update Date: 12/07/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 0648687665
  • Enrollment ID: I20210318000817

Medical Identifiers

Medical identifiers for Kenndal Soto such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1093317133NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner APRN.CNP.0028440 (Ohio)Secondary
363L00000XNurse Practitioner 4704299368 (Michigan)Secondary
363LA2100XNurse Practitioner - Acute Care APRN.CNP.0028440 (Ohio)Secondary
363LA2100XNurse Practitioner - Acute Care 4704299368 (Michigan)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kenndal Soto allows following entities to bill medicare on her behalf.
Entity NameHenry Ford Health System
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1104900455
PECOS PAC ID: 0547178311
Enrollment ID: O20031210000341
Entity NamePromedica Northwest Ohio Cardiology Consultants Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780820555
PECOS PAC ID: 4981752938
Enrollment ID: O20090504000036

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenndal Soto is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kenndal Soto, AGACNP-BC
1 Ford Pl Ste 3a,
Detroit, MI 48202-3450

Ph: (313) 874-4806		Kenndal Soto, AGACNP-BC
2799 W Grand Blvd,
Detroit, MI 48202-2608

Ph: (800) 653-6568

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.