Keith Richard Anderson, DPM is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in Hayward, Wisconsin. He graduated from medical school in 2008 and has 18 years of diverse experience with area of expertise as Podiatry. He is a member of the group practice Memorial Medical Center Inc and his current practice location is
11040 N State Road 77, Hayward, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(715) 934-4321.
Keith Richard Anderson is licensed to practice in Wisconsin (license number 1017-25) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1902185051.
Healthcare Provider's Profile
| Full Name | Keith Richard Anderson |
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| Gender | Male |
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| Speciality | Podiatry |
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| Experience | 18 Years |
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| Location | 11040 N State Road 77, Hayward, Wisconsin |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Keith Richard Anderson graduated from medical school in 2008
NPI Data:
- NPI Number: 1902185051
- Provider Enumeration Date: 08/08/2011
- Last Update Date: 05/18/2021
Medicare PECOS Information:
- PECOS PAC ID: 3274707252
- Enrollment ID: I20130510000047
Medical Identifiers
Medical identifiers for Keith Richard Anderson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1902185051 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 213E00000X | Podiatrist | 850 (Minnesota) | Secondary |
| 213E00000X | Podiatrist | 1017-25 (Wisconsin) | Secondary |
| 213EP1101X | Podiatrist - Primary Podiatric Medicine | 850 (Minnesota) | Secondary |
| 213EP1101X | Podiatrist - Primary Podiatric Medicine | 1017-25 (Wisconsin) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 850 (Minnesota) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 1017-25 (Wisconsin) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Memorial Medical Center Inc | 8022000447 | 44 |
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. Keith Richard Anderson allows following entities to bill medicare on his behalf.
| Provider Name | Memorial Medical Center Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1437179231
PECOS PAC ID: 8022000447
Enrollment ID: O20040402000938 |
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| Provider Name | Medical Services, Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1912992827
PECOS PAC ID: 9436061363
Enrollment ID: O20040914001088 |
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| Provider Name | Medical Services, Inc |
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| Provider Type | Part A Provider - Critical Access Hospital |
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| Provider 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. Keith Richard Anderson 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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Keith Richard Anderson, DPM
11040 N State Road 77,
Hayward, WI 54843-3606
Ph: (715) 934-4321 | Keith Richard Anderson, DPM
11040 N State Road 77,
Hayward, WI 54843-3606
Ph: (715) 934-4321 |
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