Individual provider Active NPI

Katherine R. Keefe, MD

  • Otolaryngology Physician
  • Salt Lake City, UT
National Provider Identifier
1922568542
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
11928776-1205 Issued in UT
Practice address
50 N Medical Dr Som 3C120
Salt Lake City, UT 84132-0001
Phone
(801) 581-8471
NPI assigned
Mar 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 11928776-1205 UT Primary

Addresses

Primary practice location

50 N Medical Dr Som 3C120
Salt Lake City, UT 84132-0001

Mailing address

50 N Medical Dr Som 3C120
Salt Lake City, UT 84132-0001
Phone (801) 581-8471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20240805003700 CA Practitioner - Otolaryngology 0648698100 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Boston University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

7300 Wyndham Dr
Sacramento, CA 95823-4913
Phone (916) 688-2000

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Jul 15, 2024 Accepting new patients
Regents of the Univ of Ca Otolaryngology CurrentSince Jul 15, 2024 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients

Locations

10850 White Rock Rd
Rancho Cordova, CA 95670

2521 Stockton Blvd
Ste 5200
Sacramento, CA 95817
Phone (916) 734-2801

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1922568542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR SOM 3C120",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR SOM 3C120",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEFE",
        "first_name": "KATHERINE",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "UT",
            "license": "11928776-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.