Brent Wayne Keenportz, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

19924 Issued in NE

Practice address

2620 W Faidley Ave
Grand Island, NE 68803-4205

Phone

(308) 398-5424

NPI assigned

Mar 29, 2007

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

Medicare fee-for-service enrollment

Enrolled in NE

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

Pathology

Education

University of Nebraska College of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CHI Health Clinic Specialty LLCGroup PAC ID 4789098443, 317 clinicians

Grand Island Dermatology PCGroup PAC ID 0244284768, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI Health St. Francis Hospital, Grand Island, NE, CCN 280023

Merit-based Incentive Payment System (MIPS)

Final score

96.6 of 100Reported as group

Promoting interoperability

96

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.

• CHI Health Clinic Specialty, LLC

  • Hospitalist Physician
  • Lincoln, NE
  • NPI 1285138065
  Medicare reassignment Care Compare group NPD
• Grand Island Dermatology PC

  • Dermatology Physician
  • Grand Island, NE
  • NPI 1609836535
  Medicare reassignment Care Compare group NPD
• The Physician Network

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1437184652
  NPD (past)

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

• Saint Francis Medical Center

  dba CHI Health St. Francis

  • General Acute Care Hospital
  • Grand Island, NE
  • NPI 1982675955
  Care Compare affiliation

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912026790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16405 WEIR ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681351218",
            "telephone_number": "402-699-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034205",
            "telephone_number": "308-398-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENPORTZ",
        "first_name": "BRENT",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NE",
            "license": "19924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keli Lynn Kavanaugh
• KC Counseling
• Kearney Eye Institute, P.C. (Grand Island Eye Institute)
• Richard Kearns, D.D.S.
• Gary L. Keck, MS, LIMHP, CPC, LADC
• Chad Keezer, MS, PLMHP
• Khloe Grace Keezer, CNA
• Keg Surgical Assisting, LLC
• Michael Keiser
• Rachel Keiser, APRN

• Anatomic Pathology & Clinical Pathology Physician in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Anatomic Pathology & Clinical Pathology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.