Individual provider Active NPI

Keith E Macksoud, CRNA

  • Certified Registered Nurse Anesthetist
  • Lincoln, RI
National Provider Identifier
1659346740
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA24719 Issued in RI
Practice address
1817 Old Louisquisset Pike
Lincoln, RI 02865-4516
Phone
(401) 727-2443
Fax
(401) 729-3476
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RNA24719 RI Primary

Addresses

Primary practice location

1817 Old Louisquisset Pike
Lincoln, RI 02865-4516

Mailing address

1817 Old Louisquisset Pike
Lincoln, RI 02865-4516
Phone (401) 727-2443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050208000101 RI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769433754 Reassigns benefits to 1 organization
I20061116000410 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769433754 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Anesthesia PCGroup PAC ID 9638255300, 33 clinicians

Practice addresses (Care Compare)

100 Morse St
Norwood, MA 02062-4679
Phone (781) 255-0362

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Mar 1, 2018 Accepting new patients
Atlantic Anesthesia, P.C. CurrentSince Mar 18, 2018 Accepting new patients
Narragansett Bay Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 8, 2018 Accepting new patients
Steward Medical Group, Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2018 Accepting new patients
Planned Parenthood of Southern New England Past Accepting new patients
Planned Parenthood of Southern New England, Inc. Nurse Anesthetist, Certified Registered PastSince Apr 15, 2017 Accepting new patients
Anesthesia Associates of Kent County, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

138 Haverhill St
Andover, MA 01810
Phone (978) 296-2302

795 Middle St
Fall River, MA 02721
Phone (508) 235-5046

800 Washington St
Norwood, MA 02062
Phone (781) 278-6264

100 Morse St
Norwood, MA 02062
Phone (781) 255-0362

211 Park St
South Attleboro, MA 02703
Phone (508) 222-5200

440 Swansea Mall Dr
Swansea, MA 02777
Phone (508) 324-1171

88 Washington St
Taunton, MA 02780
Phone (508) 828-7000

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11510/brand/1/csg/1/fhir/r4

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 1

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1659346740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 OLD LOUISQUISSET PIKE",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028654516",
            "telephone_number": "401-727-2443",
            "fax_number": "401-729-3476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 OLD LOUISQUISSET PIKE",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028654516",
            "telephone_number": "401-727-2443",
            "fax_number": "401-729-3476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKSOUD",
        "first_name": "KEITH",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "RI",
            "license": "RNA24719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.