Active NPI
Keith Medeiros, M.D.
- Cardiovascular Disease Physician
- Marlborough, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 240000
- Practice address
- 157 Union St
Marlborough, MA 01752-1228 - Phone
- (508) 624-9687
- Fax
- (508) 624-9689
- NPI assigned
- Jan 22, 2007
- Last updated
- Mar 16, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 240000 | MA | Primary |
| Nuclear Cardiology Physician | 207UN0901X | 240000 | MA |
Addresses
Primary practice location
157 Union St
Marlborough, MA 01752-1228
Mailing address
PO Box 415348
Boston, MA 02241-5348
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110096402A | Medicaid | MA |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kmedeiros11099@UmassMemorial.direct-ci.com | ||
| FHIR URL | https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- University of Massachusetts Medical School, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
112 Main St
Northborough, MA 01532-1914
119 Belmont St
Worcester, MA 01605-2903
Phone (508) 334-1000
154 E Main St
Westborough, MA 01581-1764
155 Union St
Marlborough, MA 01752-1228
Phone (508) 481-7390
157 Union St
Marlborough, MA 01752-1228
Phone (508) 486-5521
159 Union St
Suite 103
Marlborough, MA 01752-1274
Phone (508) 624-9687
198 Ayer Rd
Harvard, MA 01451-1163
Phone (978) 456-2355
201 Highland St
Suite B
Clinton, MA 01510-1037
Phone (978) 368-3731
333 SW Cutoff
Northborough, MA 01532-2130
Phone (774) 442-5695
340 Maple St
Suite 300
Marlborough, MA 01752-3200
Phone (508) 481-0202
378 Plantation St
Worcester, MA 01605-2324
Phone (508) 334-1000
55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000
60 Hospital Rd
Leominster, MA 01453-2205
Phone (978) 466-2257
640 Bolton St
Marlborough, MA 01752-3999
Phone (508) 481-0200
Hospital & facility affiliations
- Umass Memorial Medical Center/University Campus
- Marlborough Hospital
- Umass Memorial Healthalliance Hospitals
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 82.98
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marlborough Hospital Corp | Current | Accepting new patients | |
| Umass Memorial Medical Center, Inc. | Current | Accepting new patients | |
| Umass Memorial Medical Group Inc | Current | Accepting new patients | |
| Umass Memorial Medical Group, Inc. | Current | Accepting new patients |
Locations
157 Union St
Marlborough, MA 01752
Phone (508) 481-5000
159 Union St
Marlborough, MA 01752
Phone (508) 486-5454
55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862
Interoperability endpoints
- kmedeiros11099@umassmemorial.direct-ci.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Worcester, MA
- NPI 1760445373
-
dba Marlborough Hospital
- Registered Dietitian
- Marlborough, MA
- NPI 1104488170
-
- General Acute Care Hospital
- Marlborough, MA
- NPI 1396738159
-
dba Urgent Care Express at Harrington
- Urgent Care Clinic/Center
- Oxford, MA
- NPI 1982381018
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Marlborough Hospital
- Registered Dietitian
- Marlborough, MA
- NPI 1104488170
Hospital
-
- General Acute Care Hospital
- Leominster, MA
- NPI 1013995133
-
- Psychiatric Hospital Unit
- Clinton, MA
- NPI 1285171934
-
- General Acute Care Hospital
- Worcester, MA
- NPI 1831151455
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647388800000",
"number": "1699828566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 415348",
"city": "BOSTON",
"state": "MA",
"postal_code": "022415348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "157 UNION ST",
"city": "MARLBOROUGH",
"state": "MA",
"postal_code": "017521228",
"telephone_number": "508-624-9687",
"fax_number": "508-624-9689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDEIROS",
"first_name": "KEITH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2022-03-16",
"certification_date": "2022-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MA",
"license": "240000",
"primary": true
},
{
"code": "207UN0901X",
"taxonomy_group": "",
"desc": "Nuclear Medicine, Nuclear Cardiology",
"state": "MA",
"license": "240000",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110096402A",
"state": "MA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kmedeiros11099@UmassMemorial.direct-ci.com",
"affiliation": "N",
"address_1": "157 Union St",
"city": "Marlborough",
"state": "MA",
"country_code": "US",
"postal_code": "017521228",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "157 Union St",
"city": "Marlborough",
"state": "MA",
"country_code": "US",
"postal_code": "017521228",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Marlborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.