Individual provider Active NPI

Brendan J. Keys, NP

  • Nurse Practitioner
  • Bethpage, NY
National Provider Identifier
1043296833
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F334247-1 Issued in NY
Practice address
4295 Hempstead Tpke
Bethpage, NY 11714-5713
Phone
(516) 579-6000
NPI assigned
Dec 22, 2005
Last updated
Jun 6, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F334247-1 NY Primary

Addresses

Primary practice location

4295 Hempstead Tpke
Bethpage, NY 11714-5713

Mailing address

PO Box 826186
Philadelphia, PA 19182-6186
Phone (866) 898-7142

Other identifiers 2

IdentifierTypeStateIssuer
02523857MedicaidNY
0472G1OtherNYBLUECROSS BLUESHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040524000195 NY Practitioner - Nurse Practitioner 2567453988 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F334247-1NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
Internal Medicine Associates, PC CurrentSince Dec 18, 2020 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
Internal Medicine Associates, PC CurrentSince Dec 18, 2020 Accepting new patients
Winthrop Community Medical Affiliates PC Past Accepting new patients
Island Emergency Medical Services, P.C. Past Accepting new patients

Locations

1300 Franklin Ave
Ste ML6
Garden City, NY 11530
Phone (516) 353-1900

1300 Franklin Ave
Ste Ul
Garden City, NY 11530
Phone (516) 663-2224

25710 Union Tpke
Glen Oaks, NY 11004
Phone (718) 343-7200

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

585 Broadway
Massapequa, NY 11758
Phone (516) 360-2020

120 Mineola Blvd
Ste 600
Mineola, NY 11501
Phone (516) 663-4525

5499 Route 347
Mount Sinai, NY 11766
Phone (631) 331-3910

21422 73rd Ave
Oakland Gdns, NY 11364
Phone (718) 347-3500

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

243 Boyle Rd
Selden, NY 11784
Phone (631) 320-1247

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212710400000",
    "number": "1043296833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 826186",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191826186",
            "telephone_number": "866-898-7142",
            "fax_number": "770-237-1723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4295 HEMPSTEAD TPKE",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145713",
            "telephone_number": "516-579-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYS",
        "first_name": "BRENDAN",
        "middle_name": "J.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2008-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F334247-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02523857",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "0472G1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethpage, NY

Sources for this page

Verify at the official NPI Registry.