Keith A Clement (NPI# 1528058732, PAC ID# 9739129453) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1528058732 |
| PAC ID by PECOS | 9739129453 |
| Professional Enrollment ID | I20050511000846 |
| Full Name | Keith A Clement |
| Organization Legal Name | HEALTHSOURCE MEDICAL SERVICES, PLLC |
| Address |
3001 Express Dr N Suite 104 Islandia NY 11749-5301 |
| Phone Number | 6314350110 |
| Gender | M |
| Credential | NP |
| Graduation Year | 2000 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 1557495876 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330154 | MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASES |
| Address | Phone | Organization |
|---|---|---|
| 3001 Express Dr N, Suite 104, Islandia, NY 11749-5301 | 6314350110 | HEALTHSOURCE MEDICAL SERVICES, PLLC |
| 1275 York Ave, New York, NY 10065-6007 | 2126392000 | MEMORIAL ANESTHESIOLOGY GROUP |
| Organization Legal Name | HEALTHSOURCE MEDICAL SERVICES, PLLC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Beth A. Murray | Nurse Practitioner | Healthsource Medical Services, Pllc | 3001 Express Dr N, Suite 104, Islandia, NY 11749-5301 |
| Marissa Grosskopf | Physician Assistant | Healthsource Medical Services, Pllc | 3001 Express Dr N, Suite 104, Islandia, NY 11749-5301 |
| Jill Farrell | Nurse Practitioner | Healthsource Medical Services, Pllc | 3001 Express Dr N, Suite 104, Islandia, NY 11749-5301 |
| John F Folan | Internal Medicine | Healthsource Medical Services, Pllc | 3001 Express Dr N, Suite 104, Islandia, NY 11749-5301 |
| Kristin Marie Kelly | Nurse Practitioner | Healthsource Medical Services, Pllc | 3001 Express Dr N, Suite 104, Islandia, NY 11749-5301 |
| Street Address |
3001 EXPRESS DR N SUITE 104 |
| City | ISLANDIA |
| State | NY |
| Zip | 11749-5301 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Beth A. Murray | Nurse Practitioner | Healthsource Medical Services, Pllc | 3001 Express Dr N, Suite 104, Islandia, NY 11749-5301 |
| Francesca V La Rosa | Family Medicine | North Shore-lij Medical PC | 3001 Express Dr N, Islandia, NY 11749-5301 |
| Marissa Grosskopf | Physician Assistant | Healthsource Medical Services, Pllc | 3001 Express Dr N, Suite 104, Islandia, NY 11749-5301 |
| Jill Farrell | Nurse Practitioner | Healthsource Medical Services, Pllc | 3001 Express Dr N, Suite 104, Islandia, NY 11749-5301 |
| John F Folan | Internal Medicine | Healthsource Medical Services, Pllc | 3001 Express Dr N, Suite 104, Islandia, NY 11749-5301 |
| Kristin Marie Kelly | Nurse Practitioner | Healthsource Medical Services, Pllc | 3001 Express Dr N, Suite 104, Islandia, NY 11749-5301 |
| Nithya K Gopal | Obstetrics/gynecology | North Shore-lij Ob-gyn PC | 3001 Express Dr N, Islandia, NY 11749-5301 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David L Shapiro | Chiropractic | 1717 Veterans Memorial Hwy, Suite 1, Islandia, NY 11749-1532 | |
| Rodney P Coe | Ophthalmology | James M. Maisel Md Pllc | 1455 Veterans Hwy, Hauppauge, NY 11749-4836 |
| James M Maisel | Ophthalmology | James M. Maisel Md Pllc | 1455 Veterans Hwy, Hauppauge, NY 11749-4836 |
| Robert M Pollina | Vascular Surgery | Suffolk Vascular Associates, Pllc | 1324 Motor Pkwy, Suite 101, Hauppauge, NY 11749-5226 |
| Phyllis L Reischmann | Physical Therapy | 1770 Motor Pkwy, Suite 202, Islandia, NY 11749-5260 | |
| Jigna Jhaveri | Radiation Oncology | Integrated Medical Professionals Pllc | 1324 Motor Pkwy, Islandia, NY 11749-5262 |
| Anthony P Alessi | Otolaryngology | Ent and Allergy Associates LLP | 2929 Expressway Dr N, Suite 225, Islandia, NY 11749-5313 |
| Edward J Lipinsky | Otolaryngology | Ent and Allergy Associates LLP | 2929 Expressway Dr N, Suite 225, Islandia, NY 11749-5313 |
| City | ISLANDIA |
| Zip Code | 11749 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | ISLANDIA + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Keith A Clement.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.