Keith Denis, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

20822 15TH Dr
Bayside, NY 11360-1135

Phone

(631) 383-3137

NPI assigned

Sep 28, 2015

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

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

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.

• Mid Island Medical Associates, PLLC

  • Internal Medicine Physician
  • Center Moriches, NY
  • NPI 1023905247
  Medicare reassignment
• Olaf Butchma DO PC

  • Internal Medicine Physician
  • Flushing, NY
  • NPI 1164054524
  Medicare reassignment

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443398400000",
    "number": "1386014793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20822 15TH DR",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601135",
            "telephone_number": "631-383-3137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20822 15TH DR",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601135",
            "telephone_number": "631-383-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENIS",
        "first_name": "KEITH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-28",
        "last_updated": "2015-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yessenia Delacuesta
• Mercedes Virginia Delgado, L.AC.
• Tania Deliard, L.P.N.
• John Edward Deloria, MD
• Lauren Demaria, LCSW
• Chantal Dennis-George, LMSW
• Dentistry by Sherry
• Anisio Deoliveira, CCC-SLP
• Elizabeth Depaola, PT, DPT
• Lisa Deranieri

• Surgical Physician Assistant in Bayside, NY
• Providers in Bayside, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2015; 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.