NPIMap

Individual provider Active NPI

Keith M Ferris, PA

  • Medical Physician Assistant
  • Toledo, OH
National Provider Identifier
1144228925
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50001382 Issued in OH
Practice address
2142 N Cove Blvd
Toledo, OH 43606-3895
Phone
(419) 291-5318
Fax
(419) 291-6430
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 50001382 OH Primary

Addresses

Primary practice location

2142 N Cove Blvd
Toledo, OH 43606-3895

Mailing address

2428 Heatherglen Dr
Maumee, OH 43537-1028
Phone (419) 868-1349

Other identifiers 1

IdentifierTypeStateIssuer
0070822MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kferris13423@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070801000386 OH Practitioner - Physician Assistant 8820189178 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000

2901 N Reynolds Rd
Toledo, OH 43606
Phone (419) 578-7700

5700 Monroe St
Sylvania, OH 43560-2767
Phone (567) 585-0005

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50001382OHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Feb 5, 2012 Accepting new patients
Haematology-Oncology Associates of Ohio and Michigan PC Current Accepting new patients
Promedica Central Physicians CurrentSince Feb 5, 2012 Accepting new patients
The Toledo Hospital CurrentSince Dec 20, 1999 Accepting new patients
The Toledo Hospital CurrentSince Dec 20, 1999 Accepting new patients
Consultants in Laboratory Medicine of Greater Toledo Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2801 Bay Park Dr
Oregon, OH 43616
Phone (419) 690-7652

5700 Monroe St
Unit 101
Sylvania, OH 43560
Phone (419) 291-6777

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

3909 Woodley Rd
Ste 200
Toledo, OH 43606
Phone (419) 291-6777

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

Interoperability endpoints

  • Direct secure messaging: kferris13423@direct.promedica.org

Organizations & group practices 8

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 2

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1144228925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 HEATHERGLEN DR",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371028",
            "telephone_number": "419-868-1349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 N COVE BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063895",
            "telephone_number": "419-291-5318",
            "fax_number": "419-291-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRIS",
        "first_name": "KEITH",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50001382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0070822",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kferris13423@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.