Individual provider Active NPI

Stacy Keen, CRNP

  • Urology Physician
  • Philadelphia, PA
National Provider Identifier
1649923095
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
SPO2546 Issued in PA
Practice address
10800 Knights Rd
Philadelphia, PA 19114-4200
Phone
(215) 632-7888
NPI assigned
Jan 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X SPO2546 PA Primary

Addresses

Primary practice location

10800 Knights Rd
Philadelphia, PA 19114-4200

Mailing address

10800 Knights Rd
Philadelphia, PA 19114-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220224000113 PA Practitioner - Nurse Practitioner 1052705613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aria Health Physician ServicesGroup PAC ID 3577467018, 456 clinicians

Practice addresses (Care Compare)

240 Middletown Blvd
Suite 107
Langhorne, PA 19047-1832
Phone (215) 506-1001

Hospital & facility affiliations

  • Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115
  • Jefferson Abington Hospital Hospital, Abington, PA, CCN 390231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SPO2546PAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Health Physician Services CurrentSince Feb 1, 2022 Accepting new patients
Aria Health Physician Services Urology CurrentSince Feb 1, 2022 Accepting new patients
Aria Health Physician Services Current Accepting new patients
Aria Health Physician Services Past Accepting new patients

Locations

380 N Oxford Valley Rd
Langhorne, PA 19047
Phone (215) 949-5000

240 Middletown Blvd
Ste 107
Langhorne, PA 19047
Phone (215) 506-1001

3998 Red Lion Rd
Philadelphia, PA 19114
Phone (215) 612-4060

3998 Red Lion Rd
Ste 305
Philadelphia, PA 19114
Phone (215) 281-3000

10800 Knights Rd
Philadelphia, PA 19114
Phone (215) 612-2610

5000 Frankford Ave
Ste 1B
Philadelphia, PA 19124
Phone (215) 583-2355

2137 Welsh Rd
Ste 2D
Philadelphia, PA 19115
Phone (215) 673-9492

Organizations & group practices 4

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 2

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": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1649923095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "215-632-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEN",
        "first_name": "STACY",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "SPO2546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.