Jack P Keith, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

013034 Issued in ME

Practice address

45 Golder St
Lewiston, ME 04240-6033

Phone

(207) 755-3715

Fax

(207) 755-3728

NPI assigned

Aug 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY

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

Anesthesiology

Education

University of Texas Medical School at San Antonio, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bassett Healthcare Hospital, Cooperstown, NY, CCN 330136
• Aurelia Osborn Fox Memorial Hospital Hospital, Oneonta, NY, CCN 330085
• Cobleskill Regional Hospital Hospital, Cobleskill, NY, CCN 331320

Merit-based Incentive Payment System (MIPS)

Final score

92.62 of 100Reported as apm

Quality

77.97

Promoting interoperability

98

Improvement activities

40

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.

• Mary Imogene Bassett Hospital

  • Multi-Specialty Clinic/Center
  • Cooperstown, NY
  • NPI 1083664221
  Medicare reassignment Care Compare group NPD
• Bassett Hospital of Schoharie County

  • Critical Access Hospital
  • Cobleskill, NY
  • NPI 1891862579
  Medicare reassignment
• Little Falls Hospital

  • Critical Access Hospital
  • Little Falls, NY
  • NPI 1558321919
  Medicare reassignment
• O'Connor Hospital

  • Critical Access Hospital
  • Delhi, NY
  • NPI 1891728192
  Medicare reassignment
• Mary Imogene Bassett Hospital

  • Specialty Pharmacy
  • Oneonta, NY
  • NPI 1174419196
  NPD

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

• Aurelia Osborn Fox Memorial Hospital Society

  • General Acute Care Hospital
  • Oneonta, NY
  • NPI 1578529954
  Care Compare affiliation
• Bassett Hospital of Schoharie County

  • Critical Access Hospital
  • Cobleskill, NY
  • NPI 1689741985
  Care Compare affiliation
• Bassett Hospital of Schoharie County

  • Critical Access Hospital
  • Cobleskill, NY
  • NPI 1891862579
  Care Compare affiliation
• Mary Imogene Bassett Hospital

  • Rural Acute Care Hospital
  • Cooperstown, NY
  • NPI 1780600577
  Care Compare affiliation

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272240000000",
    "number": "1750393203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1823",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042411823",
            "telephone_number": "207-755-3715",
            "fax_number": "207-755-3728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 GOLDER ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406033",
            "telephone_number": "207-755-3715",
            "fax_number": "207-755-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "JACK",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2010-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ME",
            "license": "013034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050029135",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "002622",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "316040099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Akosua Kavi, PMHNP-BC
• Hannah R Kazal, MD, SCM
• Dawn Marie Kearns, CADC
• Kassandra Kee, PTA
• Judy Keenan-Bower
• Tina M Kell, DDS
• Laurie M Keller, OTR/L
• Sokharath Keller, FNP-BC
• Shana Juliet Kelley-Cohen, LCSW
• Michael E Kelley, MD

• Anesthesiology Physician in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Anesthesiology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; 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.