Individual provider Active NPI

Michael Jay Keyes Jr., M.D.

  • Emergency Medicine Physician
  • Rochester, NY
National Provider Identifier
1174630073
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
249107 Issued in NY
Practice address
601 Elmwood Ave
Box 655
Rochester, NY 14642-0001
Phone
(585) 275-9555
Fax
(585) 785-8234
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 249107 NY Primary

Addresses

Primary practice location

601 Elmwood Ave
Box 655
Rochester, NY 14642-0001

Mailing address

601 Elmwood Ave
Box 655
Rochester, NY 14642-0001

Other identifiers 1

IdentifierTypeStateIssuer
03015836MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090210000478 NY Practitioner - Emergency Medicine 6204991151 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
249107NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newark Wayne Community Hospital CurrentSince Apr 30, 2013 Accepting new patients
Newark Wayne Community Hospital CurrentSince Apr 30, 2013 Accepting new patients
Rochester General Hospital CurrentSince Feb 15, 2010 Accepting new patients
Rochester General Hospital CurrentSince Feb 15, 2010 Accepting new patients
Rochester General Hospital Current Accepting new patients

Locations

1200 Driving Park Ave
Newark, NY 14513
Phone (315) 332-2266

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

601 Elmwood Ave
#655
Rochester, NY 14642
Phone (585) 275-9555

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Organizations & group practices 5

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272499200000",
    "number": "1174630073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 655",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 655",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-9555",
            "fax_number": "585-785-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYES",
        "first_name": "MICHAEL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2010-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "249107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03015836",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.