Katie Keenan, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Hayward, Wisconsin. Her current practice location is
11040 N State Road 77, Hayward, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(715) 934-4321.
Katie Keenan is licensed to practice in Wisconsin (license number 13412-33) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1730892589.
Provider's Profile
| Full Name | Katie Keenan |
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| Gender | Female |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 11040 N State Road 77, Hayward, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1730892589
- Provider Enumeration Date: 12/26/2022
- Last Update Date: 12/26/2022
Medicare PECOS Information:
- PECOS PAC ID: 3577935790
- Enrollment ID: I20230215002295
Medical Identifiers
Medical identifiers for Katie Keenan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1730892589 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | 13412-33 (Wisconsin) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Katie Keenan allows following entities to bill medicare on her behalf.
| Entity Name | Memorial Medical Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1437179231
PECOS PAC ID: 8022000447
Enrollment ID: O20040402000938 |
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| Entity Name | Medical Services, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1912992827
PECOS PAC ID: 9436061363
Enrollment ID: O20040914001088 |
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| Entity Name | Medical Services, Inc |
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| Entity Type | Part A Provider - Critical Access Hospital |
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| Entity Identifiers | NPI Number: 1912992827
PECOS PAC ID: 9436061363
Enrollment ID: O20061104000208 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Katie Keenan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Katie Keenan,
W3494 Hamilton Rd,
Springbrook, WI 54875-9301
Ph: (940) 435-2407 | Katie Keenan,
11040 N State Road 77,
Hayward, WI 54843-3606
Ph: (715) 934-4321 |
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