Individual provider Active NPI

Jenna Ann Keelan, MD

  • Pediatric Cardiology Physician
  • Dallas, TX
National Provider Identifier
1326466491
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
T1980 Issued in TX
Practice address
5323 Harry Hines Blvd
Dallas, TX 75390-1559
Phone
(214) 730-5437
NPI assigned
Apr 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X T1980 TX Primary

Addresses

Primary practice location

5323 Harry Hines Blvd
Dallas, TX 75390-1559

Mailing address

PO Box 845347
Dallas, TX 75284
Phone (214) 730-5437

Other names 1

  • Jenna Ann Piccininni Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20211021000066 TX Practitioner - Pediatric Medicine 0345586939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
New York University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

1935 Medical District Dr
Dallas, TX 75235-7701
Phone (214) 456-6745

Hospital & facility affiliations

  • Childrens Medical Ctr of Dallas Hospital, Dallas, TX, CCN 453302

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T1980TXMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 1, 2021 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 1, 2021 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

420 E 6th St
Ste 202
Odessa, TX 79761
Phone (214) 648-9618

7609 Preston Rd
Plano, TX 75024
Phone (214) 456-2444

7211 Preston Rd
Plano, TX 75024
Phone (469) 303-3000

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1326466491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75284",
            "telephone_number": "214-730-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753901559",
            "telephone_number": "214-730-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEELAN",
        "first_name": "JENNA",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-04",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TX",
            "license": "T1980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "PICCININNI",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.