Active NPI
Megan Anne Keating, PA
- Physician Assistant
- Fort Wayne, IN
National Provider Identifier
1174384143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10004263A
- Practice address
- 7333 W Jefferson Blvd
Fort Wayne, IN 46804-6280 - Phone
- (260) 458-3830
- NPI assigned
- Jan 17, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10004263A | IN | Primary |
Addresses
Primary practice location
7333 W Jefferson Blvd
Fort Wayne, IN 46804-6280
Mailing address
7333 W Jefferson Blvd
Fort Wayne, IN 46804-6280
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
900 Johnson St
Elkhart, IN 46514-3328
Phone (574) 747-8004
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pic Indiana PC | Current | Accepting new patients |
Locations
900 Johnson St
#A
Elkhart, IN 46514
900 Johnson St
Elkhart, IN 46514
Phone (574) 747-8004
924 W Pike St
Goshen, IN 46526
Phone (574) 312-7056
Organizations & group practices 2
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.
-
- Urgent Care Clinic/Center
- Mishawaka, IN
- NPI 1942546890
-
- General Practice Physician
- Fort Wayne, IN
- NPI 1619918026
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707177600000",
"number": "1174384143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7333 W JEFFERSON BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468046280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7333 W JEFFERSON BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468046280",
"telephone_number": "260-458-3830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEATING",
"first_name": "MEGAN",
"middle_name": "ANNE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-17",
"last_updated": "2024-02-06",
"certification_date": "2024-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10004263A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.