Eileen F Keane, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

6169 Issued in CT

Practice address

374 Grand Ave
New Haven, CT 06513-3733

Phone

(203) 777-7411

Fax

(203) 777-8506

NPI assigned

Aug 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Family Health Center of Worcester, Inc.

  • Federally Qualified Health Center (FQHC)
  • Worcester, MA
  • NPI 1144514316
  NPD (past)
• Family Health Center of Worcester, Inc.

  • Federally Qualified Health Center (FQHC)
  • Worcester, MA
  • NPI 1225323777
  NPD (past)
• Family Health Center of Worcester, Inc.

  • Community/Retail Pharmacy
  • Worcester, MA
  • NPI 1528996071
  NPD (past)
• Family Health Center of Worcester, Inc.

  • Federally Qualified Health Center (FQHC)
  • Worcester, MA
  • NPI 1720373251
  NPD (past)
• Family Health Center of Worcester, Inc.

  • Federally Qualified Health Center (FQHC)
  • Worcester, MA
  • NPI 1720647209
  NPD (past)
• Family Health Center of Worcester, Inc.

  • Federally Qualified Health Center (FQHC)
  • Worcester, MA
  • NPI 1770878225
  NPD (past)
• Family Health Center of Worcester, Inc.

  • Federally Qualified Health Center (FQHC)
  • Worcester, MA
  • NPI 1780183913
  NPD (past)
• Family Health Center of Worcester, Inc.

  • Clinic Pharmacy
  • Worcester, MA
  • NPI 1790614295
  NPD (past)
• Family Health Center of Worcester, Inc.

  • Federally Qualified Health Center (FQHC)
  • Worcester, MA
  • NPI 1801181334
  NPD (past)
• Family Health Center of Worcester, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Worcester, MA
  • NPI 1992987630
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1962413401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133733",
            "telephone_number": "203-777-7411",
            "fax_number": "203-777-8506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133733",
            "telephone_number": "203-777-7411",
            "fax_number": "203-777-8506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEANE",
        "first_name": "EILEEN",
        "middle_name": "F",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "CT",
            "license": "006169",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "6169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NP9903",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-GROUP",
            "identifier": "Y10141",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1300709",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON SELECT",
            "identifier": "56780",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sundes Kazmir, M.D.
• Jesper W Ke
• Emily Keane-Layman, RN
• Ashley Elizabeth Keane, DO
• Charis Willard Keane, MD
• Kimberly Keane, PA-C
• Alison Catherine Kearns, MD, PHD
• Thomas John Kearns, MD
• Karly Regina Keating, LCSW
• Martha Kebeh

• Pediatric Nurse Practitioner in New Haven, CT
• Providers in New Haven, CT by specialty
• Pediatric Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.