Keshea Oneva Williams

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

027770 Issued in NY

Practice address

396 Saratoga Ave Apt 5M
Brooklyn, NY 11233-4894

Phone

(347) 944-3064

NPI assigned

Oct 13, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Keshea Tyrell Professional name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Kingsbrook Medical Associates, PC

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1104112838
  Medicare reassignment
• Kingsbrook Medical Associates PC

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1770844797

  Single Specialty

  NPD

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1235891532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 SARATOGA AVE APT 5M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112334894",
            "telephone_number": "347-944-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 SARATOGA AVE APT 5M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112334894",
            "telephone_number": "347-944-3064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KESHEA",
        "middle_name": "ONEVA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KESHEA",
            "last_name": "TYRELL",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Keisha Williams
• Keisha F Williams, LPN
• Keith Williams, D.C.
• Kennisha Aliza Williams
• Kerese N Williams
• Kriston Williams
• La Shemah Racquel Williams, LCSW
• Latasha Williams
• Latrina Williams
• Leslie F Williams, LCSW

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.