Active NPI
Amy Killeen, M.D.
- Diagnostic Radiology Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 4301510821
- Practice address
- 3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746 - Phone
- (616) 363-7272
- Fax
- (616) 361-5828
- NPI assigned
- Apr 20, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD61182884 | WA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | MO | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | WA | ||
| Diagnostic Radiology Physician | 2085R0202X | 4301510821 | MI | Primary |
Addresses
Primary practice location
3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Mailing address
3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone (616) 363-7272
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Tufts University School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Tacoma, WA 98422
Phone (616) 363-7272
103 W Raye St
Seattle, WA 98119-2363
Phone (616) 363-7272
3827 Densmore Ave N
Seattle, WA 98103-8237
Phone (616) 363-7272
Hospital & facility affiliations
- Spectrum Health
- Bronson Methodist Hospital
- Mymichigan Medical Center Midland
- Lakeland Hospital, St Joseph
- Bronson Battle Creek Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301510821 | MI | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tra-Minw P S | Current | Accepting new patients | |
| Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance | Current | Accepting new patients | |
| Advanced Radiology Services PC | Diagnostic Radiology | Current | Accepting new patients |
| Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance | Current | Accepting new patients | |
| Union Avenue Open MRI LLC | Current | Accepting new patients | |
| Tra-Minw P S | Current | Accepting new patients |
Locations
100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680
3264 N Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 391-6001
34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100
222 15th Ave SE
Puyallup, WA 98372
3402 S 18th St
Tacoma, WA 98405
Phone (253) 383-1099
1304 Fawcett Ave
Ste 100
Tacoma, WA 98402
Phone (253) 680-3372
2502 S Union Ave
Tacoma, WA 98405
Phone (253) 759-5900
Organizations & group practices 7
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.
-
- Radiology Clinic/Center
- Tacoma, WA
- NPI 1083802946
-
- Radiology Clinic/Center
- Tacoma, WA
- NPI 1396814166
-
- Radiology Clinic/Center
- Tacoma, WA
- NPI 1568531242
-
- Radiology Clinic/Center
- Bonney Lake, WA
- NPI 1699063354
-
- Radiology Clinic/Center
- Federal Way, WA
- NPI 1184790032
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Battle Creek, MI
- NPI 1083644579
-
- General Acute Care Hospital
- Kalamazoo, MI
- NPI 1831116441
-
- General Acute Care Hospital
- Saint Joseph, MI
- NPI 1134220031
-
- General Acute Care Hospital
- Midland, MI
- NPI 1376973149
-
- General Acute Care Hospital
- Midland, MI
- NPI 1902841414
-
- Critical Access Hospital
- Hastings, MI
- NPI 1932695525
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716336000000",
"number": "1861889693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3264 N EVERGREEN DR NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259746",
"telephone_number": "616-363-7272",
"fax_number": "616-361-5828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3264 N EVERGREEN DR NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259746",
"telephone_number": "616-363-7272",
"fax_number": "616-361-5828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILLEEN",
"first_name": "AMY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-20",
"last_updated": "2024-05-22",
"certification_date": "2024-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WA",
"license": "MD61182884",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MO",
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "WA",
"license": null,
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MI",
"license": "4301510821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.