Mitchell Fadoul Keamy III, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

5653 Issued in NV

Practice address

2850 S Mojave Rd Lot a
Las Vegas, NV 89121

Phone

(702) 386-4700

Fax

(702) 386-4701

NPI assigned

Jul 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DE

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mkeamy13022@direct.umcsn.com

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.

• Surgical Anesthesia Services, LLP

  • Anesthesiology Physician
  • Las Vegas, NV
  • NPI 1407807142
  NPD (past)

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1265431241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3157 N RAINBOW BLVD # 518",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891084578",
            "telephone_number": "702-877-8661",
            "fax_number": "702-877-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 S MOJAVE RD LOT A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89121",
            "telephone_number": "702-386-4700",
            "fax_number": "702-386-4701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 W Charleston Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891022179",
            "country_code": "US",
            "telephone_number": "702-877-8661",
            "fax_number": "702-877-5140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEAMY",
        "first_name": "MITCHELL",
        "middle_name": "FADOUL",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "5653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100504191",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P0169392",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vinh Ke
• Desiree Kealey
• Hidie Kealoha
• April Marie Kealy
• Lisa Keam
• Christina Chheav Keang
• Dawn Kearney
• Joseph Kearney
• Telaira Kearney
• Jennifer Lee Kearns

• Anesthesiology Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Anesthesiology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.