KEENAN C. WANAMAKER (DO) – Vascular Surgery Physician, NPI 1972508968
Vascular Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
141 VASCULAR SURGERY in AZ
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Provider Addresses for KEENAN C. WANAMAKER (DO)
3810 NORTHDALE BLVD STE 150
TAMPA, FL 336241871
Phone: (813) 961-1331
Fax: (888) 812-8191
Type: Mailing
East McDowell Road, Big Palm Trailer Park, Phoenix, Maricopa County, Arizona, 85018-7608, United States
PHOENIX, AZ 850062607
Phone: (800) 991-6117
Fax: (888) 812-8191
Type: Location
7085 SYDNEY CURV
MONTGOMERY, AL 361173509
Phone: (334) 246-4774
Fax: (334) 246-2450
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 59 Open Payments records for all available years, with a total value of $4,203.
Total Amount is formed as General ($4,203) + Research ($0) + Ownership ($0) = $4,203.
Last reported payment date: 2024-12-31 • Largest payer in this snapshot: Abbott Laboratories ($1,473).
Total Amount
$4,203
General + Research + Ownership
Payments
59
Total payment records
General Amount
$4,203
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $1,473 |
| CVRx, Inc. | $1,180 |
| AngioDynamics, Inc. | $636 |
| Endologix LLC | $227 |
| Boston Scientific Corporation | $115 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-05-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040407000916 | I | Vascular Surgery | AZ | TBD |
| I20160715000124 | I | Vascular Surgery | IL | TBD |
| I20210519000015 | I | Vascular Surgery | AL | TBD |
| I20220505002561 | I | Vascular Surgery | KS | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33624)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| VASCULAR SURGERY | TN | 93971 | Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers | 20 | 19 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Cardiovascular Disease (Cardiology), Interventional Cardiology | AZ | |
| Cardiovascular Disease (Cardiology) | AZ | |
| Nurse Practitioner | AZ | |
| Physician Assistant | MI | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | AZ | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | TX | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | AZ | |
| Family Practice, Internal Medicine | MT | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | ID | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | AZ |
Reviews
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