Individual provider Active NPI

Thomas P Keenan, M.D.

  • Ophthalmology Physician
  • Winchester, VA
National Provider Identifier
1164456307
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0101025849 Issued in VA
Practice address
190 Campus Blvd Ste 210
Winchester, VA 22601-2872
Phone
(540) 536-5820
Fax
(540) 536-5821
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0101025849 VA Primary

Addresses

Primary practice location

190 Campus Blvd Ste 210
Winchester, VA 22601-2872

Mailing address

220 Campus Blvd Ste 100
Winchester, VA 22601-2888
Phone (540) 536-5100

Other identifiers 2

IdentifierTypeStateIssuer
006307761MedicaidVA
005808OtherBLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tkeenan124460@soc.inova.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20120202000504 VA Practitioner - Ophthalmology 3375616428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Georgetown University School of Medicine, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Physician Enterprise IncGroup PAC ID 9931268091, 176 clinicians

Practice addresses (Care Compare)

1000 N Shenandoah Ave
Front Royal, VA 22630-3547
Phone (540) 636-0300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101025849VAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physician Enterprise, Inc Current Accepting new patients
Valley Physician Enterprise, Inc. Ophthalmology CurrentSince Aug 1, 2018 Accepting new patients
Valley Physician Enterprise, Inc. CurrentSince Aug 1, 2018 Accepting new patients

Locations

1000 N Shenandoah Ave
Front Royal, VA 22630
Phone (540) 636-0300

220 Campus Blvd
Ste 100
Winchester, VA 22601

190 Campus Blvd
Ste 210
Winchester, VA 22601
Phone (540) 536-5820

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1164456307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CAMPUS BLVD STE 100",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012888",
            "telephone_number": "540-536-5100",
            "fax_number": "540-536-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 CAMPUS BLVD STE 210",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012872",
            "telephone_number": "540-536-5820",
            "fax_number": "540-536-5821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "THOMAS",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101025849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006307761",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "005808",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkeenan124460@soc.inova.org",
            "affiliation": "N",
            "address_1": "190 Campus Blvd Ste 210",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226012872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.