Active NPI
Russell D Keinath, M.D.
- Gastroenterology Physician
- Ypsilanti, MI
National Provider Identifier
1427037878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 4301043636
- Practice address
- 5300 Elliott Dr
Ypsilanti, MI 48197-8632 - Phone
- (734) 434-6262
- Fax
- (734) 712-2820
- NPI assigned
- Jan 13, 2006
- Last updated
- Jan 12, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 4301043636 | MI | Primary |
Addresses
Primary practice location
5300 Elliott Dr
Ypsilanti, MI 48197-8632
Mailing address
5300 Elliott Dr
Ypsilanti, MI 48197-8632
Phone (734) 434-6262
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4404030 | Other | MI | AETNA |
| 021534 | Other | MI | MIDWEST HEALTH PLAN |
| 2403058001 | Other | MI | CIGNA |
| 0H14989 | Other | MI | BCBSM GROUP |
| 1728793 | Medicaid | MI | |
| 0H14989 | Other | MI | BCBS GROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301043636 | MI | MD | Gastroenterology Physician |
Organizations & group practices 1
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": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515715200000",
"number": "1427037878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5300 ELLIOTT DR",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481978632",
"telephone_number": "734-434-6262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5300 ELLIOTT DR",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481978632",
"telephone_number": "734-434-6262",
"fax_number": "734-712-2820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEINATH",
"first_name": "RUSSELL",
"middle_name": "D",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-13",
"last_updated": "2018-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MI",
"license": "4301043636",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4404030",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDWEST HEALTH PLAN",
"identifier": "021534",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2403058001",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM GROUP",
"identifier": "0H14989",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1728793",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GROUP",
"identifier": "0H14989",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.