Michael J Keenan, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

01046708 Issued in IN

Practice address

2802 Leonard Dr
Valparaiso, IN 46383

Phone

(219) 531-0355

Fax

(219) 531-2855

NPI assigned

Jan 31, 2006

Last updated

Sep 11, 2020By the provider in NPPES

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN, MI2 enrollments

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 2

Specialty

Otolaryngology

Education

Saint Louis University School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Ear Nose Throat and Allergy Specialists PCGroup PAC ID 4183868094, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
• Corewell Health Zeeland Hospital Hospital, Zeeland, MI, CCN 230003

Merit-based Incentive Payment System (MIPS)

Final score

85.85 of 100Reported as group

Quality

81.22

Promoting interoperability

100

Improvement activities

40

Cost

71.61

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.keenan.1@2340.direct.athenahealth.com
• Direct secure messaging: mkeenan1642733@epic00.corewelldirect.org

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.

• Michigan Ear, Nose, Throat, and Allergy Specialists, PC

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Holland, MI
  • NPI 1780029991
  Medicare reassignment Care Compare group NPD
• Allergy Asthma Care P.C.

  • Specialist
  • Valparaiso, IN
  • NPI 1265440390
  Medicare reassignment NPD
• Porter Physician Services LLC

  • Family Medicine Physician
  • Valparaiso, IN
  • NPI 1508075680
  Medicare reassignment NPD
• Associated Ear Nose and Throat Specialists, PC

  • Specialist
  • Valparaiso, IN
  • NPI 1487607768
  Authorized official Same address or phone
• West Michigan Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Zeeland, MI
  • NPI 1568981975
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pennock Hospital

  dba Corewell Health Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Hospitals

  dba Corewell Health Grand Rapids Hospital

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation
• Zeeland Community Hospital

  dba Corewell Health Zeeland Hospital

  • General Acute Care Hospital
  • Zeeland, MI
  • NPI 1275536344
  Care Compare affiliation

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1558332197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 KELLE DR",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463048708",
            "telephone_number": "219-364-3616",
            "fax_number": "219-364-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 LEONARD DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "46383",
            "telephone_number": "219-531-0355",
            "fax_number": "219-531-2855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 E US Highway 6 Ste 220",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463838948",
            "country_code": "US",
            "telephone_number": "219-983-6220",
            "fax_number": "219-983-6029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01046708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200138900",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.keenan.1@2340.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "2802 Leonard Dr",
            "city": "Valparaiso",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robin W Kawecki, D.C.
• Tamara Lynn Kay, DNP, FNP-BC
• John Emmanuel Kazonis, D.C.
• Bryttanie Keen-Ketchum
• Kristin Keen, PTA
• Breanne Elizabeth Kehoe
• Keith a. Gingerich, M.D., P.C.
• Tyler Kelley
• Morgan Kelly, PTA
• Kelsey Chiropractic PC

• Otolaryngology Physician in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Otolaryngology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.