Individual provider Active NPI

Jonathan Patrick Keenan, M.D.

  • Family Medicine Physician
  • Lutz, FL
National Provider Identifier
1326451733
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME150708 Issued in FL
Practice address
15953 N Florida Ave
Lutz, FL 33549-8102
Phone
(813) 513-0808
Fax
(833) 973-3680
NPI assigned
Jun 4, 2014
Last updated
Feb 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME150708 FL Primary

Addresses

Primary practice location

15953 N Florida Ave
Lutz, FL 33549-8102

Mailing address

15953 N Florida Ave
Lutz, FL 33549-8102
Phone (813) 513-0808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210506001907 FL Practitioner - Family Practice 1355637901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
George Washington University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health First Privia Medical GroupGroup PAC ID 3173965993, 247 clinicians

Practice addresses (Care Compare)

140 6TH Ave
Indialantic, FL 32903-3204
Phone (321) 312-3501

15953 N Flordia Ave
Lutz, FL 33549-8102
Phone (202) 709-5665

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME150708FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Family Health LLC Family Medicine Current Accepting new patients
Privia Medical Group Florida, LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

140 6th Ave
Indialantic, FL 32903
Phone (321) 312-3501

15953 N Florida Ave
Lutz, FL 33549
Phone (813) 513-0808

989 Sebastian Blvd
Unit 3
Sebastian, FL 32958
Phone (727) 617-1777

Interoperability endpoints

  • Direct secure messaging: jonathan.keenan.1@8042.direct.athenahealth.com

Organizations & group practices 2

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": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1326451733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15953 N FLORIDA AVE",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335498102",
            "telephone_number": "813-513-0808",
            "fax_number": "833-973-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15953 N FLORIDA AVE",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335498102",
            "telephone_number": "813-513-0808",
            "fax_number": "833-973-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "JONATHAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME150708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.