Individual provider Active NPI

Mary Kathleen Keown, M.D.

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1437470531
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
271462 Issued in NY
Practice address
534 W 135TH St
New York, NY 10031-8644
Phone
(212) 491-2300
Fax
(212) 491-2323
NPI assigned
Jun 13, 2010
Last updated
Oct 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 271462 NY Primary

Addresses

Primary practice location

534 W 135TH St
New York, NY 10031-8644

Mailing address

622 W 168TH St # Vc417
New York, NY 10032-3720
Phone (212) 305-6227

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131031001167 NY Practitioner - Pediatric Medicine 8426283342 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell Pediatrics Current Accepting new patients
Weill Medical College of Cornell CurrentSince Sep 15, 2013 Accepting new patients
Weill Medical College of Cornell CurrentSince Jan 1, 2014 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Trustees of Columbia University in the City of New York Pediatrics CurrentSince Jun 1, 2018 Accepting new patients
Weill Medical College of Cornell Pediatrics CurrentSince Sep 15, 2013 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Aug 1, 2017 Accepting new patients
Trustees of Columbia University in the City of New York Pediatrics CurrentSince Aug 1, 2017 Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

3959 Broadway
New York, NY 10032
Phone (212) 304-7297

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

525 E 68th St
#M6
New York, NY 10065
Phone (212) 746-3558

534 W 135th St
New York, NY 10031
Phone (212) 491-2300

610 W 158th St
Fl 2
New York, NY 10032
Phone (212) 304-6408

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

622 W 168th St
#417
New York, NY 10032
Phone (212) 305-6227

630 W 168th St
New York, NY 10032
Phone (212) 305-1948

2026 Richmond Rd
Staten Island, NY 10306
Phone (212) 305-2300

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: mkk9005@direct.nyp.org

Organizations & group practices 9

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": "1276387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1437470531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST # VC417",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-6227",
            "fax_number": "212-305-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 W 135TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100318644",
            "telephone_number": "212-491-2300",
            "fax_number": "212-491-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOWN",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-13",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "271462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.