Individual provider Active NPI

Dana Christine Keddie, PA-C

  • Physician Assistant
  • Pennington, NJ
National Provider Identifier
1760646012
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00135700 Issued in NJ
Practice address
2 Capital Way Ste 505
Pennington, NJ 08534-2521
Phone
(609) 537-7000
Fax
(609) 537-7070
NPI assigned
Jul 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA-002400L PA
Physician Assistant 363A00000X 25MP00135700 NJ Primary

Addresses

Primary practice location

2 Capital Way Ste 505
Pennington, NJ 08534-2521

Mailing address

2 Capital Way Ste 505
Pennington, NJ 08534-2521
Phone (609) 537-7000

Other practice location 1

5501 Old York Rd
aemc- ct surgery levy 3 east
Philadelphia, PA 19141-3018
Phone (215) 456-8270

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dana.keddie.1@12833.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110420000462 NJ Practitioner - Physician Assistant 2365627155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Hahnemann University College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Health Medical GroupGroup PAC ID 7618264532, 442 clinicians

Practice addresses (Care Compare)

1 Capital Way
Pennington, NJ 08534-2520
Phone (609) 303-4244

2 Capital Way
Pennington, NJ 08534-2521

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.91 of 100Reported as apm
Quality
79.42
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00135700NJMDPhysician Assistant
MA-002400LPAMDSurgical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: dana.keddie.1@12833.direct.athenahealth.com

Organizations & group practices 1

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 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": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1760646012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CAPITAL WAY STE 505",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342521",
            "telephone_number": "609-537-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CAPITAL WAY STE 505",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342521",
            "telephone_number": "609-537-7000",
            "fax_number": "609-537-7070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 Old York Rd",
            "address_2": "aemc- ct surgery levy 3 east",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "215-456-8270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEDDIE",
        "first_name": "DANA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-16",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA-002400L",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00135700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dana.keddie.1@12833.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2 Capital Way Ste 505",
            "city": "Pennington",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "085342521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pennington, NJ

Sources for this page

Verify at the official NPI Registry.