Individual provider Active NPI

Keene Wilson Bryant, P.A.

  • Physician Assistant
  • Cincinnati, OH
National Provider Identifier
1750666970
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003394 Issued in OH
Practice address
11140 Montgomery Rd
Cincinnati, OH 45249-2309
Phone
(513) 221-5500
Fax
(513) 221-1962
NPI assigned
Oct 19, 2011
Last updated
Jun 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.003394 OH Primary

Addresses

Primary practice location

11140 Montgomery Rd
Cincinnati, OH 45249-2309

Mailing address

11140 Montgomery Rd
Cincinnati, OH 45249-2309
Phone (513) 221-5500

Other identifiers 1

IdentifierTypeStateIssuer
0070176MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111229000415 OH Practitioner - Physician Assistant 3971779620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christ Hospital Orthopedic Associates III LLCGroup PAC ID 8820282924, 33 clinicians

Practice addresses (Care Compare)

11140 Montgomery Rd
Cincinnati, OH 45249-2309
Phone (513) 221-5500

2139 Auburn Ave
Cincinnati, OH 45219-2906
Phone (513) 221-5500

608 Reading Rd
Mason, OH 45040-3001
Phone (513) 221-5500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.86 of 100Reported as group
Quality
79.11
Promoting interoperability
100
Improvement activities
40
Cost
77.09

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.003394OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Consultants of Cincinnati, Inc. Past Accepting new patients

Organizations & group practices 2

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.

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": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1750666970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11140 MONTGOMERY RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452492309",
            "telephone_number": "513-221-5500",
            "fax_number": "513-221-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11140 MONTGOMERY RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452492309",
            "telephone_number": "513-221-5500",
            "fax_number": "513-221-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "KEENE",
        "middle_name": "WILSON",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-19",
        "last_updated": "2022-06-01",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0070176",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.