Keith Alan Christiansen, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

25MA08972100 Issued in NJ

Practice address

14-01 Broadway Ste 3
Fair Lawn, NJ 07410-2008

Phone

(201) 855-8455

NPI assigned

Oct 8, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Urology

Education

Georgetown University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Josephs Medical Group PCGroup PAC ID 8628470325, 217 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St Josephs Medical Group PC

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1205425519
  Medicare reassignment Care Compare group NPD
• Sovereign Medical Group LLC

  • Urology Physician
  • Oradell, NJ
  • NPI 1710282082
  Medicare reassignment NPD
• St. Joseph'S Healthcare, Inc.

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1497791297
  Medicare reassignment NPD
• Sovereign Medical Group, LLC

  • Durable Medical Equipment & Medical Supplies
  • Glen Rock, NJ
  • NPI 1801266275
  NPD

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

• St Josephs University Medical Center Inc.

  • General Acute Care Hospital
  • Paterson, NJ
  • NPI 1669462420
  Care Compare affiliation

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1679724694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 HUDSON ST",
            "address_2": "APT 1005",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305656",
            "telephone_number": "917-903-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14-01 BROADWAY STE 3",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102008",
            "telephone_number": "201-855-8455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15-01 Broadway",
            "address_purpose": "LOCATION",
            "city": "Fair Lawn",
            "state": "NJ",
            "postal_code": "074106003",
            "country_code": "US",
            "telephone_number": "201-791-4544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTIANSEN",
        "first_name": "KEITH",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-08",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MA08972100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Yoorim Choi, MA, LPC, LMHC
• Choicepoint LLC
• Choicepoint LLC
• Choicepoint LLC
• Lindsey Christensen, LCSW
• Michelle Chu, PSY.D.
• Jiyeon Chung, DDS, MS
• Laurie Cicio, MS, CCC-SLP, BCS-CL
• John E Cintineo, D.C.
• Renee A Clacer, M.S., L.AC.

• Urology Physician in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Urology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; 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.