Individual provider Active NPI

Keith A Beck, DPM

  • Foot & Ankle Surgery Podiatrist
  • Waukesha, WI
National Provider Identifier
1104877034
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
791-025 Issued in WI
Practice address
113 W Sunset Dr
Waukesha, WI 53189-7604
Phone
(262) 547-2900
Fax
(262) 547-1440
NPI assigned
May 15, 2006
Last updated
Oct 31, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 791-025 WI Primary

Addresses

Primary practice location

113 W Sunset Dr
Waukesha, WI 53189-7604

Mailing address

4448 Bramblewood Dr
Hartford, WI 53027-9591
Phone (414) 530-1220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070430000422 WI Practitioner - Podiatry 4183720691 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthdrive Podiatry Group PCGroup PAC ID 3375446958, 105 clinicians

Practice addresses (Care Compare)

1426 S W Ave
Suite B
Waukesha, WI 53189-7476
Phone (262) 547-2900

200 S Executive Dr
Suite 101
Brookfield, WI 53005-4216
Phone (888) 964-6681

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1233
Removal or shaving of skin growth343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
791-025WIMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Foot and Ankle, S.C. Foot & Ankle Surgery CurrentSince Feb 1, 2002 Accepting new patients
Healthdrive Podiatry Group, PC Foot & Ankle Surgery CurrentSince Jan 9, 2023 Accepting new patients
Healthdrive Podiatry Group, PC CurrentSince Jan 9, 2023 Accepting new patients

Locations

200 S Executive Dr
Ste 101
Brookfield, WI 53005
Phone (262) 262-6707

113 W Sunset Dr
Waukesha, WI 53189
Phone (262) 547-2900

1426 S West Ave
Ste B
Waukesha, WI 53189
Phone (262) 547-2900

Organizations & group practices 3

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1104877034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4448 BRAMBLEWOOD DR",
            "city": "HARTFORD",
            "state": "WI",
            "postal_code": "530279591",
            "telephone_number": "414-530-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W SUNSET DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531897604",
            "telephone_number": "262-547-2900",
            "fax_number": "262-547-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECK",
        "first_name": "KEITH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WI",
            "license": "791-025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.