Individual provider Active NPI

Keith E Swanson, MD

  • Internal Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1508952862
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME147925 Issued in FL
Practice address
10080 SW Innovation Way Ste 201
Port St Lucie, FL 34987-2129
Phone
(772) 287-5200
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 10075 ND
Internal Medicine Physician 207R00000X ME147925 FL Primary

Addresses

Primary practice location

10080 SW Innovation Way Ste 201
Port St Lucie, FL 34987-2129

Mailing address

10080 SW Innovation Way Ste 201
Port St Lucie, FL 34987-2129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20041109001161 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Gastroenterology 6406819598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of North Dakota School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10080 SW Innovation Way
Suite 201
Port St Lucie, FL 34987-2129
Phone (772) 344-3811

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.68 of 100Reported as group
Quality
60.2
Promoting interoperability
99
Improvement activities
40
Cost
75.2

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Memorial Medical Center Inc CurrentSince Jul 7, 2024 Accepting new patients
Martin Memorial Medical Center Inc CurrentSince Jul 7, 2024 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Clinic Pharmacy Inc Past Accepting new patients
Martin Memorial Physician Corporation Inc Past Accepting new patients

Locations

10080 SW Innovation Way
Ste 201
Port St Lucie, FL 34987
Phone (772) 344-3811

314 SE Hospital Ave
Stuart, FL 34994
Phone (772) 221-2006

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

509 SE Riverside Dr
Stuart, FL 34994
Phone (772) 223-2300

3725 11th Cir
Vero Beach, FL 32960
Phone (772) 410-0155

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: kswanson84271@direct.ccf.org

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1508952862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10080 SW INNOVATION WAY STE 201",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10080 SW INNOVATION WAY STE 201",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872129",
            "telephone_number": "772-287-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "KEITH",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "10075",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME147925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.