Keith G Ancona, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

221658 Issued in NY

Practice address

300 E Main St
Suite 5
Smithtown, NY 11787-2900

Phone

(631) 979-6466

Fax

(631) 979-6475

NPI assigned

Apr 27, 2006

Last updated

Jul 13, 2026By 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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: keith.ancona.p1@direct.cwpw.nextgenshare.com

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.

• Boston Children's Health Physicians, LLP

  • Pediatrics Physician
  • Hawthorne, NY
  • NPI 1467454967
  Medicare reassignment NPD
• Boston Childrens Health Physicians LLP

  dba Boston Childrens Health Physicians Pediatric Endocrinology Division

  • Clinical Medical Laboratory
  • Sleepy Hollow, NY
  • NPI 1588651079
  NPD
• St Charles Hospital Corp

  dba St. Charles Hospital

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1164481529
  NPD (past)

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619934205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MAIN ST",
            "address_2": "SUITE 5",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872900",
            "telephone_number": "631-979-6466",
            "fax_number": "631-979-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E MAIN ST",
            "address_2": "SUITE 5",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872900",
            "telephone_number": "631-979-6466",
            "fax_number": "631-979-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANCONA",
        "first_name": "KEITH",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "221658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02413734",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Snehal P Amin, M.D.
• Lisa Nelly Amorin, M.D.
• Madeline Amzler, LMSW
• An Physician Assistant PC
• Salah Sadeek Anani
• Richard C Ancona, MD
• Julia Marie Andenmatten, LPN
• Elizabeth Anderson
• Jennifer Anderson, M.S.
• Teresa Anderson

• Pediatrics Physician in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.