NPIMap

Individual provider Active NPI

Keith Shute, MD

  • Family Medicine Physician
  • Berlin, NH
National Provider Identifier
1588666267
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9083 Issued in NH
Practice address
59 Page Hill Rd
Berlin, NH 03570-3531
Phone
(603) 752-2900
Fax
(603) 752-3727
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9083 NH Primary

Addresses

Primary practice location

59 Page Hill Rd
Berlin, NH 03570-3531

Mailing address

133 Pleasant St
Berlin, NH 03570-2006
Phone (603) 752-2040

Other identifiers 9

IdentifierTypeStateIssuer
9083OtherNHSTATE LICENSE #
0109410YPNH02OtherNHANTHEM BC/BS
3072597MedicaidNH
RE7915OtherMEDICARE GROUP PTAN
99003818MedicaidNH
RE289602OtherPTAN MEDICARE
3626045001OtherNHCIGNA HEALTHCARE
5830418OtherAETNA GROUP
P00100702OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040519000737 NH Practitioner - Family Practice 2567370018 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Vermont College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

59 Page Hill Rd
Berlin, NH 03570-3531
Phone (603) 752-2900

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Androscoggin Valley Hospital, Inc. CurrentSince Apr 1, 2009 Accepting new patients
Androscoggin Valley Hospital Inc Family Medicine CurrentSince Apr 1, 2009 Accepting new patients
Androscoggin Valley Hospital, Inc. Family Medicine CurrentSince Nov 18, 2024 Accepting new patients
Coos County Family Health Services, Inc Family Medicine CurrentSince Mar 28, 2004 Accepting new patients
Coos County Family Health Services, Inc CurrentSince Mar 28, 2004 Accepting new patients
Coos County Family Health Services, Inc Family Medicine Past Accepting new patients
Coos County Family Health Services, Inc. Family Medicine Past Accepting new patients

Locations

59 Page Hill Rd
Berlin, NH 03570
Phone (603) 752-2200

133 Pleasant St
Berlin, NH 03570
Phone (603) 752-2040

2 Broadway Ave
Gorham, NH 03581
Phone (603) 466-2741

Organizations & group practices 7

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 4

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1588666267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 PLEASANT ST",
            "city": "BERLIN",
            "state": "NH",
            "postal_code": "035702006",
            "telephone_number": "603-752-2040",
            "fax_number": "603-752-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 PAGE HILL RD",
            "city": "BERLIN",
            "state": "NH",
            "postal_code": "035703531",
            "telephone_number": "603-752-2900",
            "fax_number": "603-752-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTE",
        "first_name": "KEITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "9083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "9083",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "0109410YPNH02",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3072597",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "RE7915",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99003818",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN MEDICARE",
            "identifier": "RE289602",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "3626045001",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GROUP",
            "identifier": "5830418",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00100702",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, NH

Sources for this page

Verify at the official NPI Registry.