Individual provider Active NPI

Keith Habeeb, D.O

  • Emergency Medicine Physician
  • Nashville, TN
National Provider Identifier
1063774537
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS016952 Issued in PA
Practice address
2300 Patterson St
Nashville, TN 37203-1538
Phone
(732) 718-5431
NPI assigned
Jun 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 3291 TN
Emergency Medicine Physician 207P00000X OS016952 PA Primary

Addresses

Primary practice location

2300 Patterson St
Nashville, TN 37203-1538

Mailing address

1212 Laurel St Apt 815
Nashville, TN 37203-5573
Phone (732) 718-5431

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KEITH.HABEEB@hca1.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20180122001541 TN Practitioner - Emergency MedicinePractitioner - Critical Care (Intensivists) 5496977530 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Critical Care (Intensivists)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

2300 Patterson St
Nashville, TN 37203-1538
Phone (561) 997-0821

Hospital & facility affiliations

  • Tristar Centennial Medical Center Hospital, Nashville, TN, CCN 440161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3291TNMDPsychologist
OS016952PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intensive Care Consortium Inc CurrentSince Sep 2, 2017 Accepting new patients
Emergency Medicine Services of TN, PC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients

Locations

2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500

Organizations & group practices 2

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.

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": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1063774537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 LAUREL ST APT 815",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372035573",
            "telephone_number": "732-718-5431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 PATTERSON ST",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031538",
            "telephone_number": "732-718-5431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABEEB",
        "first_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-11",
        "last_updated": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TN",
            "license": "3291",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS016952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KEITH.HABEEB@hca1.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "2300 Patterson St",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372031538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.