Mr Jacob Bradley Keith, AGACNP - Medicare Nurse Practitioner in Phoenix, AZ

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Mr Jacob Bradley Keith, AGACNP is a medicare enrolled "Nurse Practitioner - Acute Care" in Phoenix, Arizona. His current practice location is 500 W Thomas Rd Ste 500, Phoenix, Arizona. You can reach out to his office (for appointments etc.) via phone at (602) 406-4000.

Mr Jacob Bradley Keith is licensed to practice in Arizona (license number 306974) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1285300541.

Contact Information

Mr Jacob Bradley Keith, AGACNP
500 W Thomas Rd Ste 500,
Phoenix, AZ 85013-4220
(602) 406-4000
(602) 406-6498

Map and Direction




Provider's Profile

Full NameMr Jacob Bradley Keith
GenderMale
SpecialityNurse Practitioner - Acute Care
Location500 W Thomas Rd Ste 500, Phoenix, Arizona
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1285300541
  • Provider Enumeration Date: 08/18/2021
  • Last Update Date: 05/16/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 1153714084
  • Enrollment ID: I20220216002790

Medical Identifiers

Medical identifiers for Mr Jacob Bradley Keith such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1285300541NPI-NPPES
200810MedicaidAZ

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2100XNurse Practitioner - Acute Care 306974 (Arizona)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. Mr Jacob Bradley Keith allows following entities to bill medicare on his behalf.
Entity NameThe Queens Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1487693586
PECOS PAC ID: 3476454067
Enrollment ID: O20040116000366
Entity NameQueens University Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1891441382
PECOS PAC ID: 2466831557
Enrollment ID: O20220621000534

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. Mr Jacob Bradley Keith 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 AddressPractice Location Address
Mr Jacob Bradley Keith, AGACNP
500 W Thomas Rd Ste 500,
Phoenix, AZ 85013-4220

Ph: (602) 406-4000		Mr Jacob Bradley Keith, AGACNP
500 W Thomas Rd Ste 500,
Phoenix, AZ 85013-4220

Ph: (602) 406-4000

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.