Individual provider Active NPI

Patrick McKearney, DO

  • Anesthesiology Physician
  • Grand Rapids, MI
National Provider Identifier
1144715632
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
5101027384 Issued in MI
Practice address
100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone
(616) 364-4200
Fax
(616) 364-7347
NPI assigned
Jun 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 5101027384 MI Primary

Addresses

Primary practice location

100 Michigan St NE
Grand Rapids, MI 49503-2560

Mailing address

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9493
Phone (616) 364-4200

Other practice location 1

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9493
Phone (616) 364-4200

Other identifiers 1

IdentifierTypeStateIssuer
5101027384OtherMIMICHIGAN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20251028000151 IN Practitioner - Anesthesiology 7719234368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Anesthesia Services, LLCGroup PAC ID 7719891027, 94 clinicians

Practice addresses (Care Compare)

2001 W 86TH St
Indianapolis, IN 46260-1902
Phone (317) 338-2345

Hospital & facility affiliations

  • Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
  • Ascension St Vincent Fishers Hospital, Fishers, IN, CCN 150181
  • Ascension St Vincent Carmel Hospital, Carmel, IN, CCN 150157

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Anesthesia Services, LLC Anesthesiology CurrentSince Aug 7, 2025 Accepting new patients

Locations

12188 N Meridian St
Carmel, IN 46032
Phone (317) 569-8250

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

Interoperability endpoints

  • Direct secure messaging: pmckearney778223@direct.hfhs.org

Organizations & group practices 1

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 4

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": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1144715632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259493",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Evergreen Dr NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495259493",
            "country_code": "US",
            "telephone_number": "616-364-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKEARNEY",
        "first_name": "PATRICK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-27",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "5101027384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LICENSE",
            "identifier": "5101027384",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.