Individual ProviderKenneth RogersInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address6100 Pan American East Fwy NE, 100, Albuquerque, NM 87109-3427(505) 727-6200PECOS EnrollmentBased on the most recent information from CMS, provider Kenneth Rogers does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1043316169Provider TypeIndividualFull NameRogers, KennethCredentialMDGenderMaleSole ProprietorNoEnumeration Date9/15/2006Last Updated8/12/2015Contact InformationPractice LocationPractice Address6100 Pan American East Fwy NE, 100, Albuquerque, NM 87109-3427Phone(505) 727-6200Fax(505) 727-9590Mailing LocationMailing Address6100 Pan American East Fwy NE, 100, Albuquerque, NM 87109-3427Phone(505) 727-6200Fax(505) 727-9590Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense80242New MexicoCode173000000XDescriptionLegal MedicineOther Service ProvidersLicense80242New MexicoProvider IdentifiersIDDescriptionIssuerID00017236DescriptionMedicaidIssuerUnlistedNew Mexico