Individual provider Active NPI

Jeffrey A Keyser, DO

  • Surgery Physician
  • Ephrata, PA
National Provider Identifier
1346233400
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
OS-004694L Issued in PA
Practice address
804 Grandview Dr Ste 2
Ephrata, PA 17522
Phone
(717) 466-2500
Fax
(717) 733-7865
NPI assigned
Aug 24, 2005
Last updated
Aug 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X OS-004694L PA Primary

Addresses

Primary practice location

804 Grandview Dr Ste 2
Ephrata, PA 17522

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 733-4644

Other identifiers 18

IdentifierTypeStateIssuer
50009561OtherCAPITAL BLUE CROSS PA
067541OtherMEDICARE GROUP
20020200OtherMERCY HEALTH PLAN PA
60116300OtherTHREE RIVERS HEALTH PLAN
7107465OtherAETNA USHC NONHMO
9338687OtherCIGNA PA
09786390009MedicaidPA
1458636OtherKEYSTONE CENTRAL PA
3101927OtherAETNA USHC HMO
427186OtherBLUE SHIELD OF PA
0078174890004MedicaidPA
2144133000OtherKEYSTONE EAST PA
50009554OtherCAPITAL BLUE CROSS PA
020054619OtherRAILROAD MEDICARE
PA0008OtherRAILROAD MEDICARE
1528721OtherGATEWAY PA
KE1458636OtherBLUE SHIELD OF PA
20020196OtherMERCY HEALTH PLAN PA

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
I20090601000327 PA Practitioner - General Surgery 7315096955 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS-004694LPAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ephrata Community Hospital Current Accepting new patients
Wellspan Medical Group CurrentSince May 5, 2017 Accepting new patients
Ephrata Community Hospital CurrentSince Mar 26, 2009 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince May 5, 2017 Accepting new patients
Chet Phitayakorn, MD PC Past Accepting new patients

Locations

169 Martin Ave
Ephrata, PA 17522
Phone (717) 733-0311

175 Martin Ave
Ste 125
Ephrata, PA 17522

175 Martin Ave
Ste 355
Ephrata, PA 17522
Phone (717) 733-4667

804 Grandview Dr
Ste 2
Ephrata, PA 17522
Phone (717) 466-2500

804 Grandview Dr
Ste 3
Ephrata, PA 17522
Phone (717) 721-6994

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

Organizations & group practices 6

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1346233400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-733-4644",
            "fax_number": "717-733-7865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 GRANDVIEW DR STE 2",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "17522",
            "telephone_number": "717-466-2500",
            "fax_number": "717-733-7865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYSER",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "OS-004694L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS PA",
            "identifier": "50009561",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "067541",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLAN PA",
            "identifier": "20020200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS HEALTH PLAN",
            "identifier": "60116300",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHC NONHMO",
            "identifier": "7107465",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PA",
            "identifier": "9338687",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09786390009",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE CENTRAL PA",
            "identifier": "1458636",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHC HMO",
            "identifier": "3101927",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF PA",
            "identifier": "427186",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0078174890004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE EAST PA",
            "identifier": "2144133000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS PA",
            "identifier": "50009554",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020054619",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "PA0008",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY PA",
            "identifier": "1528721",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF PA",
            "identifier": "KE1458636",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLAN PA",
            "identifier": "20020196",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephrata, PA

Sources for this page

Verify at the official NPI Registry.