Keith D Jorgensen, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

7086 Issued in NH

Practice address

44 Birch St
Suite 304
Derry, NH 03038-2752

Phone

(603) 432-8104

NPI assigned

Feb 13, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Otolaryngology

Education

Rush Medical College of Rush University, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Keith D. Jorgensen, MD, PAGroup PAC ID 1658373568, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkland Medical Center Hospital, Derry, NH, CCN 300017
• Elliot Hospital Hospital, Manchester, NH, CCN 300012

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Keith D. Jorgensen, MD, PA

  • Otolaryngology Physician
  • Derry, NH
  • NPI 1679588339
  Medicare reassignment Care Compare group NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Elliot Hospital of the City of Manchester

  • General Acute Care Hospital
  • Manchester, NH
  • NPI 1902996028
  Care Compare affiliation
• HCA Health Services of New Hampshire Inc

  • General Acute Care Hospital
  • Derry, NH
  • NPI 1174570683
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1023081601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 BIRCH ST",
            "address_2": "SUITE 304",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030382752",
            "telephone_number": "603-432-8104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 BIRCH ST",
            "address_2": "SUITE 304",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030382752",
            "telephone_number": "603-432-8104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSEN",
        "first_name": "KEITH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NH",
            "license": "7086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30001523",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanne Bickford
• Dawn M Johnson, RN
• Janelle Jones, MS
• Jennifer Torrant Jones, D.O.
• Amruth Ram Jonnalagadda, M.D.
• Jessica E Judkins, PA-C
• Nazli Idil Kacamak
• Amiksha Parminder Kumar Kad
• Daniel F Kana, D.D.S.
• Thomas J. Karanasios, PT

• Otolaryngology Physician in Derry, NH
• Providers in Derry, NH by specialty
• Otolaryngology Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.