Dr Keith Y Miyamoto, MD is a medicare enrolled "Urology" physician in Gaylord, Michigan. He went to University Of Michigan Medical School and graduated in 1972 and has 52 years of diverse experience with area of expertise as Urology. He is a member of the group practice Munson Healthcare Otsego Memorial Hospital and his current practice location is
829 N Center Ave, Suite 160, Gaylord, Michigan. You can reach out to his office (for appointments etc.) via phone at
(989) 731-7131.
Dr Keith Y Miyamoto is licensed to practice in Michigan (license number 4301032171) 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 1609883842.
Physician's Profile
| Full Name | Dr Keith Y Miyamoto |
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| Gender | Male |
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| Speciality | Urology |
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| Experience | 52 Years |
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| Location | 829 N Center Ave, Gaylord, Michigan |
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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:
- Dr Keith Y Miyamoto attended and graduated from University Of Michigan Medical School in 1972
NPI Data:
- NPI Number: 1609883842
- Provider Enumeration Date: 08/01/2006
- Last Update Date: 12/23/2020
Medicare PECOS Information:
- PECOS PAC ID: 1759350978
- Enrollment ID: I20040927000285
Medical Identifiers
Medical identifiers for Dr Keith Y Miyamoto such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1609883842 | NPI | - | NPPES |
| OF96004 | Other | | MEDICARE GROUP NUMBER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208800000X | Urology | 4301032171 (Michigan) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Munson Healthcare Otsego Memorial Hospital | 8325942535 | 71 |
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 Y Miyamoto allows following entities to bill medicare on his behalf.
| Entity Name | Munson Healthcare Otsego Memorial Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1164628426
PECOS PAC ID: 8325942535
Enrollment ID: O20040305000525 |
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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. Dr Keith Y Miyamoto 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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Dr Keith Y Miyamoto, MD
829 N Center Ave, Suite 298,
Gaylord, MI 49735-1595
Ph: (989) 731-7708 | Dr Keith Y Miyamoto, MD
829 N Center Ave, Suite 160,
Gaylord, MI 49735-1595
Ph: (989) 731-7131 |
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