Keith A Beck, DPM
Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Waukesha, WI
NPI 1104877034 · NPPES record last updated Oct 31, 2018
Key facts
- NPI
- 1104877034
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- 791-025 (WI)
- Practice address
- 113 W Sunset Dr
Waukesha, WI 53189-7604 - Phone
- (262) 547-2900
- Fax
- (262) 547-1440
- NPI assigned
- May 15, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Healthdrive Podiatry Group PC
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
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of nail tissue | 1233 |
| Removal or shaving of skin growth | 343 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070430000422 | WI | Practitioner - Podiatry | 4183720691 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 791-025 | WI | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Foot and Ankle, S.C. | Foot & Ankle Surgery | Current |
Accepting new patients |
| Healthdrive Podiatry Group, PC | Foot & Ankle Surgery | Current |
Accepting new patients |
| Healthdrive Podiatry Group, PC | Current |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 791-025 | WI | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 480033967 | Other | RAILROAD MEDICARE | |
| 43230100 | Medicaid | WI |
Other providers in Waukesha, WI
- Heather Bear
- Ellen L Beary
- Emily Gail Beaudry
- Robert J Beaumont
- Abigail Bechtold
- Becker Audiology SC
- Kathleen A Becker
- Melissa Ann Becker
- Ryan Becker
- Tim Richard Becker
All providers in Waukesha, WI · Foot & Ankle Surgery Podiatrist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.