Edwin Keeshan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

287227 Issued in NY

Practice address

679 Montauk Hwy
Montauk, NY 11954-5340

Phone

(631) 668-3705

Fax

(631) 668-1148

NPI assigned

Jan 10, 2014

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

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

Specialty

Family Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meeting House Lane Medical Practice PCGroup PAC ID 6800972589, 125 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

89.86

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: edwin.keeshan.1@25843.direct.athenahealth.com
• Direct secure messaging: edwin.keeshan.p1@direct.shproviders.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.

• Meeting House Lane Medical Practice PC

  • Internal Medicine Physician
  • Southampton, NY
  • NPI 1902088495
  Medicare reassignment Care Compare group NPD

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

• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Southampton, NY
  • NPI 1033224704
  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Southampton, NY
  • NPI 1225507114
  Care Compare affiliation
• University Hospital at Stony Brook

  • Land Ambulance
  • Stony Brook, NY
  • NPI 1306620588

  Hospital

  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Greenport, NY
  • NPI 1881690691
  Care Compare affiliation
• University Hospital at Stony Brook

  • Clinic/Center
  • Greenport, NY
  • NPI 1932466604

  Hospital

  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Stony Brook, NY
  • NPI 1972523348
  Care Compare affiliation

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1649692690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SPRINGVILLE RD STE B",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "119462290",
            "telephone_number": "631-283-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "679 MONTAUK HWY",
            "city": "MONTAUK",
            "state": "NY",
            "postal_code": "119545340",
            "telephone_number": "631-668-3705",
            "fax_number": "631-668-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEESHAN",
        "first_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-10",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "287227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Rae Enck, LPN
• Margaret Hayes I, PT
• Jane Hegleman
• Sara Elisabeth Hogg, LCSW
• Jenna Bogetti Mental Health Counseling
• Timothy Albert Lane, M.D.
• Rachel Elizabeth Lys, P.T.
• Donald Marrone, M.D.
• Meghan Ryan Physical Therapy, PC
• Meghan Walsh PT PLLC

• Family Medicine Physician in Montauk, NY
• Providers in Montauk, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.