Dr Keith David Clancy, MD in Fort Wayne, IN

Dr Keith David Clancy, MD is a medicare enrolled "Surgery - Trauma Surgery" physician in Fort Wayne, Indiana. He went to Creighton University School Of Medicine and graduated in 1992 and has 33 years of diverse experience with area of expertise as General Surgery. He is a member of the group practice Florida Trauma Services Llc and his current practice location is 7900 W Jefferson Blvd Ste 306, Fort Wayne, Indiana. You can reach out to his office (for appointments etc.) via phone at (260) 458-3610.

Dr Keith David Clancy is licensed to practice in Indiana (license number 01079569A) 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 1164482303.

Contact Information

	Dr Keith David Clancy, MD
	7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128
	(260) 458-3610
	(260) 458-3611

Map and Direction

Physician's Profile

Full Name	Dr Keith David Clancy
Gender	Male
Speciality	General Surgery
Experience	33 Years
Location	7900 W Jefferson Blvd Ste 306, Fort Wayne, Indiana
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Keith David Clancy attended and graduated from Creighton University School Of Medicine in 1992

NPI Data:

NPI Number: 1164482303
Provider Enumeration Date: 03/23/2006
Last Update Date: 09/23/2020

Medicare PECOS Information:

PECOS PAC ID: 7012947039
Enrollment ID: I20230720000008

Medical Identifiers

Medical identifiers for Dr Keith David Clancy such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1164482303	NPI	-	NPPES
001757641	Medicaid	PA
117558	Other	PA	UNISON-WMG
562564	Other	PA	HIGHMARK BLUE SHIELD
039983	Other	PA	JOHNS HOPKINS
20006031	Other	PA	AMERIHEALTH MERCY-WMG
7731206	Other	PA	AETNA
01122002	Other	PA	CAPITAL BLUE CROSS-WMG
491516	Other	PA	MAMSI-WMG
610201	Other	MD	CAREFIRST MD BCBS
1506063	Other	PA	GATEWAY-WMG
56845	Other	PA	GEISINGER
0342984000	Other	PA	AMERIHEALTH 65 PA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	MD067578-L (Pennsylvania)	Secondary
208600000X	Surgery	036.090092 (Illinois)	Secondary
208600000X	Surgery	35.123491 (Ohio)	Secondary
208600000X	Surgery	01079569A (Indiana)	Secondary
2086S0102X	Surgery - Surgical Critical Care	MD067578-L (Pennsylvania)	Secondary
2086S0102X	Surgery - Surgical Critical Care	35.123491 (Ohio)	Secondary
2086S0127X	Surgery - Trauma Surgery	036.090092 (Illinois)	Secondary
2086S0127X	Surgery - Trauma Surgery	MD067578-L (Pennsylvania)	Secondary
2086S0127X	Surgery - Trauma Surgery	35.123491 (Ohio)	Secondary
2086S0127X	Surgery - Trauma Surgery	01079569A (Indiana)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Orange Park Medical Center	Orange park, FL	Hospital
Lake City Medical Center	Lake city, FL	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Florida Trauma Services Llc	3971985938	91

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. Dr Keith David Clancy allows following entities to bill medicare on his behalf.

Entity Name	Florida Trauma Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1477296952 PECOS PAC ID: 3971985938 Enrollment ID: O20220808001578

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. Dr Keith David Clancy 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
Dr Keith David Clancy, MD 6920 Pointe Inverness Way Ste 200, Fort Wayne, IN 46804-7934 Ph: (260) 479-3514	Dr Keith David Clancy, MD 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128 Ph: (260) 458-3610

Reviews and Comments

Surgery Doctors in Fort Wayne, IN

Dr. Barton Wade Williams, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 11108 Parkview Circle Dr Ste 5100, Fort Wayne, IN 46845 Phone: 260-266-2800 Fax: 260-266-2805
Dr. Ian H. Cook, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 2121 Lake Ave, Veterans Affairs Medical Center, Fort Wayne, IN 46805 Phone: 260-426-5431
Dr. Patricia L Clark, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 11050 Parkview Circle Dr, Fort Wayne, IN 46845 Phone: 833-724-8326 Fax: 260-425-6845
Dr. Paul Mitchell Bauer, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: Lutheran Hospital, 7950 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-435-7001
Lindsay B Hardley, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 11050 Parkview Circle Dr, Fort Wayne, IN 46845 Phone: 833-724-8326 Fax: 260-425-6845
Kingsley Saahene Okai, MD Surgery Medicare: Medicare Enrolled Practice Location: 7910 W Jefferson Blvd Ste 112, Fort Wayne, IN 46804 Phone: 260-969-7121 Fax: 260-479-4614

Dr Keith David Clancy, MD - Medicare General Surgery in Fort Wayne, IN