Craig Michael Keanna, M.D., F.A.A.P.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

034961 Issued in CT

Practice address

1062 Barnes Rd
Wallingford, CT 06492-6012

Phone

(203) 294-6328

NPI assigned

Jun 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: craig.keanna.npi1881635662.phpct@direct.optumcare.masshiway.net

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.

• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053

  Pediatrics

  Medicare reassignment NPD

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1881635662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1062 BARNES RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064926012",
            "telephone_number": "203-294-6328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1062 BARNES RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064926012",
            "telephone_number": "203-294-6328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEANNA",
        "first_name": "CRAIG",
        "middle_name": "MICHAEL",
        "credential": "M.D., F.A.A.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "034961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001349613",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marjorie Kanyusik, M.D.
• Steven M Kaplan, PHYSICAL THERAPIST
• Kara'S Creative Counseling
• Meghana Karande, M.D.
• Karen Kremzar OT LLC
• Elena Kelleher, DPT
• Brenna Megan Kelley, DPT
• Gina Kelley, PA-C
• Janet Kelley
• Robin Christi Kenna, PA-C

• Pediatrics Physician in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Pediatrics Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.