Individual provider Active NPI

W Alan Keogh, DO

  • Hematology & Oncology Physician
  • Upland, PA
National Provider Identifier
1205827730
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
OS0003816L Issued in PA
Practice address
1 Medical Center Blvd
Ste 341
Upland, PA 19013-3902
Phone
(610) 619-7420
Fax
(610) 876-6923
NPI assigned
Nov 3, 2005
Last updated
Jul 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X OS0003816L PA Primary
Hematology & Oncology Physician 207RH0003X 25MB07696300 NJ
Hematology & Oncology Physician 207RH0003X C20009108 DE

Addresses

Primary practice location

1 Medical Center Blvd
Ste 341
Upland, PA 19013-3902

Mailing address

5 Kirkcaldy Dr
West Chester, PA 19382-7285
Phone (610) 619-7420

Other identifiers 1

IdentifierTypeStateIssuer
001146510-0002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20111221000228 PA Practitioner - Hematology/Oncology 5395722862 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS0003816LPAMDHematology & Oncology Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1205827730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 KIRKCALDY DR",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193827285",
            "telephone_number": "610-619-7420",
            "fax_number": "610-876-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "address_2": "STE 341",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "610-619-7420",
            "fax_number": "610-876-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOGH",
        "first_name": "W ALAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PA",
            "license": "OS0003816L",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NJ",
            "license": "25MB07696300",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "DE",
            "license": "C20009108",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001146510-0002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, PA

Sources for this page

Verify at the official NPI Registry.