Daniel J Keane, DPM
Individual provider Active NPI Foot Surgery Podiatrist · Coopers Mills, ME
NPI 1982608410 · NPPES record last updated Aug 27, 2023
Key facts
- NPI
- 1982608410
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot Surgery Podiatrist 213ES0131X
- License
- 36002572 (OH)
- Practice address
- 47 Main St
Coopers Mills, ME 04341-3758 - Phone
- (207) 549-7581
- Fax
- (937) 847-8635
- NPI assigned
- Jun 13, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- William M. Scholl College of Podiatric Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Healthreach Community Health Centers
Practice addresses (Care Compare)
24 Gardiner St
Richmond, ME 04357-1336
Phone (207) 737-4359
4 Clement Way
Belgrade, ME 04917-4370
Phone (207) 660-9924
47 Main St
Cooper Mills, ME 04341
Phone (207) 549-7581
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230905001677 | ME | Practitioner - Podiatry | 8022180066 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36002572 | OH | MD | Foot Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthreach Community Health Centers | Current |
Accepting new patients | |
| Healthreach Community Health Centers | Current |
Accepting new patients | |
| Healthreach Community Health Centers | Past |
Accepting new patients | |
| Healthreach Community Health Centers | Past | Accepting new patients | |
| Healthreach Community Health Centers | Past | Accepting new patients |
Locations
7 School St
#1
Albion, ME 04910
Phone (207) 437-9388
4 Clement Way
Belgrade, ME 04917
Phone (207) 660-9924
24 Gardiner St
Richmond, ME 04357
Phone (207) 727-4359
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | 36002572 | OH | Yes |
Addresses
Primary practice location
47 Main St
Coopers Mills, ME 04341-3758
Mailing address
PO Box 727
Waterville, ME 04901-3758
Phone (207) 495-3323
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0757604 | Medicaid | OH | |
| 4237161 | Other | OH | MEDICARE PTAN |
NPI Registry JSON
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693094400000",
"number": "1982608410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 727",
"city": "WATERVILLE",
"state": "ME",
"postal_code": "049013758",
"telephone_number": "207-495-3323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 MAIN ST",
"city": "COOPERS MILLS",
"state": "ME",
"postal_code": "043413758",
"telephone_number": "207-549-7581",
"fax_number": "937-847-8635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEANE",
"first_name": "DANIEL",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-13",
"last_updated": "2023-08-27",
"certification_date": "2023-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "OH",
"license": "36002572",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0757604",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "4237161",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coopers Mills, ME
- Coopers Mills Nursing Home, Inc.
- Judith Walker Day
- Healthreach Community Health Centers
- Shannon Lynn Hunt
- Colin McCabe
- Roy S Miller
- Rachel Elizabeth Palmer
- Brooke A. Perez
- Faith Marie Sager
All providers in Coopers Mills, ME · Foot Surgery Podiatrist in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.