Individual provider Active NPI

Shevaughn M Kealy, M.D

  • Family Medicine Physician
  • Greenfield, MA
National Provider Identifier
1740625565
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
261914 Issued in MA
Practice address
143 Munson St
Greenfield, MA 01301-9694
Phone
(413) 773-8428
Fax
(413) 582-3164
NPI assigned
May 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 261914 MA Primary

Addresses

Primary practice location

143 Munson St
Greenfield, MA 01301-9694

Mailing address

Veterans Affairs Medical Center
421 North Main Street
Leeds, MA 01053-9764
Phone (413) 584-4040

Other practice location 1

424 Russell St
Hadley, MA 01035-9579
Phone (413) 253-0483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140512000632 NY Practitioner - Family Practice 9739312059 Reassigns benefits to 1 organization
I20151110000676 MA Practitioner - Family Practice 9739312059 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10 Denniston PL
Womens Health
Northampton, MA 01060-2052
Phone (413) 586-9866

12 College Hwy
Southampton, MA 01073-9406
Phone (413) 527-1105

30 Locust St
Northampton, MA 01060-2052
Phone (413) 582-2441

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
272067NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Physician of New York-Hartsdale PLLC CurrentSince Feb 1, 2014 Accepting new patients
Medexpress Urgent Care, PC - Massachusetts CurrentSince Aug 14, 2023 Accepting new patients
Mass General Brigham Medical Group Western Massachusetts Inc Past Accepting new patients

Locations

359 N Central Ave
Hartsdale, NY 10530
Phone (914) 448-2273

423 Fortress Blvd
Morgantown, WV 26508
Phone (844) 852-9510

Organizations & group practices 5

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": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1740625565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "VETERANS AFFAIRS MEDICAL CENTER",
            "address_2": "421 NORTH MAIN STREET",
            "city": "LEEDS",
            "state": "MA",
            "postal_code": "010539764",
            "telephone_number": "413-584-4040",
            "fax_number": "413-582-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 MUNSON ST",
            "city": "GREENFIELD",
            "state": "MA",
            "postal_code": "013019694",
            "telephone_number": "413-773-8428",
            "fax_number": "413-582-3164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "424 Russell St",
            "address_purpose": "LOCATION",
            "city": "Hadley",
            "state": "MA",
            "postal_code": "010359579",
            "country_code": "US",
            "telephone_number": "413-253-0483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEALY",
        "first_name": "SHEVAUGHN",
        "middle_name": "M",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-07",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "261914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, MA

Sources for this page

Verify at the official NPI Registry.