Individual provider Active NPI

Ilan Keidan, MD

  • Anesthesiology Physician
  • Gainesville, FL
National Provider Identifier
1487746558
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME83886 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone
(352) 265-8012
Fax
(352) 265-8013
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 321476 NY
Anesthesiology Physician 207L00000X ME83886 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3003

Mailing address

PO Box 918025
Orlando, FL 32891-8025
Phone (352) 265-8012

Other identifiers 1

IdentifierTypeStateIssuer
004670000MedicaidFL

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
I20240305002514 NY Practitioner - Anesthesiology 6406026780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jamaica Anesthesiologist PCGroup PAC ID 1355323460, 80 clinicians

Practice addresses (Care Compare)

4500 Parsons Blvd
Flushing, NY 11355-2205
Phone (718) 670-5631

8900 Van Wyck Expy
Jamaica, NY 11418-2832
Phone (718) 206-6088

Hospital & facility affiliations

  • Flushing Hospital Medical Center Hospital, Flushing, NY, CCN 330193

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
321476NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Anesthesiologist, PC Anesthesiology CurrentSince Jan 6, 2024 Accepting new patients

Locations

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

Networks

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

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1487746558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918025",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328918025",
            "telephone_number": "352-265-8012",
            "fax_number": "352-265-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-265-8012",
            "fax_number": "352-265-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIDAN",
        "first_name": "ILAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "321476",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME83886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004670000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.