Keley John Booth, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

22940 Issued in OK

Practice address

4401 S Western Ave
Oklahoma City, OK 73109-3413

Phone

(918) 664-9892

Fax

(918) 664-2521

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK, TX2 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

Interventional Pain ManagementAlso: Anesthesiology

Education

University of Oklahoma College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Elite Pain and Health PCGroup PAC ID 5193017085, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Onecore Health Hospital, Oklahoma City, OK, CCN 370220

Merit-based Incentive Payment System (MIPS)

Final score

23.99 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

79.95

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: keley.boothmd.p11@direct.okc.nextgenshare.com

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.

• Elite Pain & Health PC

  • Interventional Pain Medicine Physician
  • Oklahoma City, OK
  • NPI 1700235645
  Medicare reassignment Care Compare group NPD Authorized official
• Premier Anesthesia of Huntsville a Division of Premier Anesthesia LLC

  • Anesthesiology Physician
  • McAllen, TX
  • NPI 1346570355
  Medicare reassignment NPD
• Elite Pain & Health PC

  • Interventional Pain Medicine Physician
  • Moore, OK
  • NPI 1376192294
  NPD Authorized official
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

• Hospital for Special Surgery L L C

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1851344188
  Care Compare affiliation

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449446400000",
    "number": "1558387696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6491",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730706491",
            "telephone_number": "405-947-8585",
            "fax_number": "405-948-6507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093413",
            "telephone_number": "918-664-9892",
            "fax_number": "918-664-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "KELEY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2015-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "22940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200087480A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "433243ZPYY",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenya Boone
• Paula Woods Boone, LPC, LMFT
• William Omar Boone Sr.
• Charity Boos
• Aaron Ashley Booth, MD
• Korye D Booth
• Kristina Booth, MS
• Richard C. Booth, LLP
• Sara Ann Booth
• Richard Lee Boothe, MD

• Anesthesiology Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Anesthesiology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; 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.