Individual provider Active NPI

Deirdre Marie Keane, N.P.

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1982064663
Registry record updated Aug 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
341703 Issued in NY
Practice address
2959 Grand Concourse Apt 2
Bronx, NY 10468-1443
Phone
(917) 617-6823
NPI assigned
Feb 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 649306 NY
Family Nurse Practitioner 363LF0000X 341703 NY Primary

Addresses

Primary practice location

2959 Grand Concourse Apt 2
Bronx, NY 10468-1443

Mailing address

2959 Grand Concourse Apt 2
Bronx, NY 10468-1443
Phone (917) 617-6823

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
649306NYMDRegistered Nurse
341703NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Psychiatry Group CurrentSince Jul 29, 2019 Accepting new patients
Memorial Pediatric Group CurrentSince Dec 31, 2017 Accepting new patients
Mskcc Surgery Group CurrentSince Mar 1, 2020 Accepting new patients

Locations

205 E 64th St
New York, NY 10065
Phone (212) 639-3127

633 3rd Ave
New York, NY 10017

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: dkeane36107@mskcc.direct-ci.com

Organizations & group practices 3

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": "1456272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502236800000",
    "number": "1982064663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2959 GRAND CONCOURSE APT 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104681443",
            "telephone_number": "917-617-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2959 GRAND CONCOURSE APT 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104681443",
            "telephone_number": "917-617-6823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEANE",
        "first_name": "DEIRDRE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-24",
        "last_updated": "2017-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "649306",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "341703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.