Matthew Gaire Keane, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA20525 Issued in CA

Practice address

66675 Pierson Blvd
Desert Hot Springs, CA 92240-3737

Phone

(760) 676-5240

NPI assigned

Sep 29, 2009

Last updated

Apr 20, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkeane@borregomedical.directbygreenway.com
• Direct secure messaging: mkeane575778@direct.llu.edu

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.

• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment
• Southern California Emergency Medicine

  • Urgent Care Clinic/Center
  • San Bernardino, CA
  • NPI 1639314255
  Medicare reassignment
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Palm Springs, CA
  • NPI 1124073648
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Southern California Emergency Medicine

  dba Riverside Urgent Care La Sierra

  • Urgent Care Clinic/Center
  • Riverside, CA
  • NPI 1063191575
  NPD
• Southern California Emergency Medicine

  dba Moreno Beach Urgent Care Center

  • Urgent Care Clinic/Center
  • Moreno Valley, CA
  • NPI 1518380765
  NPD
• Sonotec Advanced Imaging Inc

  • Radiology Clinic/Center
  • Hemet, CA
  • NPI 1609424498
  NPD (past)
• Specialty Urgent Care, LP

  • Urgent Care Clinic/Center
  • Yucca Valley, CA
  • NPI 1841501319
  NPD (past)

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1043544778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 E BELLAMY RD",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922622522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66675 PIERSON BLVD",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922403737",
            "telephone_number": "760-676-5240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 N Waterman Ave",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924044836",
            "country_code": "US",
            "telephone_number": "909-883-8711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEANE",
        "first_name": "MATTHEW",
        "middle_name": "GAIRE",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-29",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Desert Hot Springs, CA
• Providers in Desert Hot Springs, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.