Individual provider Active NPI

Jay Brennan Keil, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1023352903
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1069485 Issued in MD
Practice address
600 N Wolfe St
Jhoc
Baltimore, MD 21287-0005
Phone
(410) 955-4694
NPI assigned
Nov 16, 2012
Last updated
Nov 16, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1069485 MD Primary

Addresses

Primary practice location

600 N Wolfe St
Jhoc
Baltimore, MD 21287-0005

Mailing address

600 N Wolfe St
Jhoc
Baltimore, MD 21287-0005
Phone (410) 955-4694

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141119000341 MD Practitioner - Physician Assistant 5890947279 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Hospital Center IncGroup PAC ID 6204739352, 90 clinicians

Practice addresses (Care Compare)

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 701-4434

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1069485MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Hospital Center, Inc. CurrentSince Jul 25, 2023 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Jan 1, 2012 Accepting new patients
Northwest Hospital Center, Inc Physician Assistant CurrentSince Jul 25, 2023 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Oct 9, 2014 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Jan 1, 2012 Accepting new patients
Northwest Hospital Center, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

2435 W Belvedere Ave
Ste 42
Baltimore, MD 21215
Phone (410) 601-5547

2435 W Belvedere Ave
Ste 56
Baltimore, MD 21215
Phone (410) 578-8632

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

Organizations & group practices 9

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1023352903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "address_2": "JHOC",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-955-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "address_2": "JHOC",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-955-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIL",
        "first_name": "JAY",
        "middle_name": "BRENNAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-16",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "1069485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.