Michael Timothy Keelan

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

578 Thorn Tree Rd
Grosse Pointe Woods, MI 48236-2737

Phone

(586) 596-8057

NPI assigned

Jan 9, 2024

Last updated

Jan 9, 2024By 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

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Humboldt Park Health Hospital, Chicago, IL, CCN 140206

Medicare enrollment (NPD)

Enrolled

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.

• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  Medicare reassignment Care Compare group
• Humboldt Park Health Emergency Medicine, LLC

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1104592120
  Medicare reassignment

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

• Humboldt Park Health

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1972594877
  Care Compare affiliation

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

{
    "created_epoch": "1704758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1659142750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 THORN TREE RD",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362737",
            "telephone_number": "586-596-8057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 THORN TREE RD",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362737",
            "telephone_number": "586-596-8057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEELAN",
        "first_name": "MICHAEL",
        "middle_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ceren Nur Karaali, MD
• Linda Karal
• Jessica Lynn Kata, CPNP-AC
• Kathleen E. Gibney DDS PC
• Hima Katkuri, MD
• Kyla-Jai Kemp
• Maya Kemp, RHIA, CPB
• Jordan Marie Kessler
• Sofia Ketels
• Ali S Khalil, MD

• Physician Assistant in Grosse Pointe Woods, MI
• Providers in Grosse Pointe Woods, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; 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.