Individual provider Active NPI

Keith A Schulze, MD

  • Urology Physician
  • Albany, OR
National Provider Identifier
1174625693
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD199584 Issued in OR
Practice address
400 Hickory St NW Ste 200
Albany, OR 97321-1700
Phone
(541) 812-5800
NPI assigned
Sep 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD00023945 WA
Urology Physician 208800000X MD199584 OR Primary

Addresses

Primary practice location

400 Hickory St NW Ste 200
Albany, OR 97321-1700

Mailing address

PO Box 1188
Corvallis, OR 97339-1188

Other identifiers 4

IdentifierTypeStateIssuer
0291737OtherWASTATE L&I
0264452OtherWASTATE L&I
0264447OtherWASTATE L&I
0264481OtherWASTATE L&I

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kschulze191768@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20051121000603 WA Practitioner - Urology 1759300635 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Medical Center Specialty Physicians LLCGroup PAC ID 2567651771, 103 clinicians

Practice addresses (Care Compare)

3900 Capital Mall Dr SW
Olympia, WA 98502-8654
Phone (360) 704-4743

601 McPhee Rd SW
BLDG 1
Olympia, WA 98502-5080
Phone (360) 706-6282

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD199584ORMDUrology Physician
MD00023945WAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince May 16, 2022 Accepting new patients
Multicare Health System CurrentSince Aug 11, 2021 Accepting new patients
Capital Medical Center Specialty Physicians, LLC Urology CurrentSince Mar 20, 2024 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Aug 11, 2021 Accepting new patients
Providence Health & Services Washington CurrentSince May 16, 2022 Accepting new patients
Providence Health & Services Washington Current Accepting new patients
Kitsap Urology Associates, PC Urology Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

149 Lilly Rd NE
Olympia, WA 98506
Phone (360) 352-3361

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

3900 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 704-4743

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: kschulze191768@samhealth.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1174625693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1188",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HICKORY ST NW STE 200",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211700",
            "telephone_number": "541-812-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULZE",
        "first_name": "KEITH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-04",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD00023945",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OR",
            "license": "MD199584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0291737",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0264452",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0264447",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0264481",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kschulze191768@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "400 Hickory St NW Ste 200",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

Verify at the official NPI Registry.