NPIMap

Individual provider Active NPI

Patrick Keogh

  • Emergency Medicine Physician
  • Edwards, CO
National Provider Identifier
1154412898
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DR46190 Issued in CO
Practice address
322 Beard Creek Rd
Suite 200
Edwards, CO 81632-1749
Phone
(970) 926-6340
Fax
(970) 926-6348
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DR46190 CO Primary
Emergency Medicine Physician 207P00000X 036-086697 IL

Addresses

Primary practice location

322 Beard Creek Rd
Suite 200
Edwards, CO 81632-1749

Mailing address

PO Box 1128
Frisco, CO 80443-1128
Phone (970) 926-6340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040719001073 IL Practitioner - Emergency MedicinePractitioner - Family Practice 9638158959 Reassigns benefits to 2 organizations
I20081103000301 CO Practitioner - Emergency Medicine 9638158959 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jersey Community HospitalGroup PAC ID 4587650445, 62 clinicians

Practice addresses (Care Compare)

400 Maple Summit Rd
Jerseyville, IL 62052-2028
Phone (618) 498-6402

Hospital & facility affiliations

  • Jersey Community Hospital Hospital, Jerseyville, IL, CCN 140059
  • Prowers Medical Center Hospital, Lamar, CO, CCN 061323

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as apm
Quality
69.5
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR46190COMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Bush Lincoln Health Center CurrentSince Mar 9, 2019 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Mar 9, 2019 Accepting new patients
Prowers County Hospital District CurrentSince Feb 14, 2013 Accepting new patients
Sarah Bush Lincoln Health Center Current Accepting new patients
Colorado Mountain Medical, PC PastSince Aug 1, 2008 Accepting new patients
HSHS Holy Family Hospital Inc Past Accepting new patients
Quantum Plus LLC Emergency Medicine Past Accepting new patients

Locations

401 Kendall Dr
Lamar, CO 81052
Phone (719) 336-4343

503 N Maple St
Effingham, IL 62401
Phone (217) 342-2121

101 E 9th St
Pana, IL 62557
Phone (217) 562-2131

650 W Taylor St
Vandalia, IL 62471
Phone (618) 283-1231

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455235200000",
    "number": "1154412898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1128",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "804431128",
            "telephone_number": "970-926-6340",
            "fax_number": "970-926-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 BEARD CREEK RD",
            "address_2": "SUITE 200",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816321749",
            "telephone_number": "970-926-6340",
            "fax_number": "970-926-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOGH",
        "first_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2016-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR46190",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-086697",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwards, CO

Sources for this page

Verify at the official NPI Registry.