PHILLIP J KEITH (M.D.) – Dermatology Physician, NPI 1073802468

PHILLIP J KEITH (M.D.) is a healthcare provider. based in Rochester, Minnesota. specializing in DERMATOLOGY. They hold the professional credentials M.D.. They hold a License No. 55676 (MN). The NPI Number for PHILLIP J KEITH (M.D.) is 1073802468

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
PHILLIP J KEITH (M.D.)
NPI
1073802468
Phone
(507) 284-2511
Address
200 1ST ST SW
Enumeration Date
6 April 2011
Last Update Date
22 October 2012

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF WISCONSIN
Secondary Phone
6517700110
Graduation Year
2011 (15 years ago)
PAC ID
9739336264
Group Practice PAC ID
1850295676
Professional Enrollment ID
I20120905000650
Address ID
MN551105131VA3555XBLVD401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

419 DERMATOLOGY in MN

Provider Addresses for PHILLIP J KEITH (M.D.)

  • 200 1ST ST SW

    ROCHESTER, MN 559050001

    Phone: (507) 284-2511

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2012-09-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-09-30 (983 days ago).

Enrollment records

1

Earliest due date

2023-09-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120905000650IDermatologyMN2023-09-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths537154$0
99213Established patient office or other outpatient visit, 20-29 minutes488374$0
88305Pathology examination of tissue using a microscope, intermediate complexity366205$0
17000Destruction of precancer skin growth, 1 growth286230$0
11102Biopsy of related skin growth, first growth200173$0
View full utilization report →

Insurance plans in this area (ZIP 55905)

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Provider's Procedures

PHILLIP J KEITH (M.D.) performs procedures in DERMATOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYMN17003Destruction of 2-14 skin growths39685

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1850295676View full group profile
NameSpecialtyState
D E R M A T O L O G YMN
D E R M A T O L O G YMN
D E R M A T O L O G YMN
D E R M A T O L O G YMN
Micrographic Dermatologic Surgery (Mds), DermatologyMN
D E R M A T O L O G YMN
D E R M A T O L O G YMN
-MN
D E R M A T O L O G YMN
D E R M A T O L O G YMN

Reviews

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Frequently asked questions

How do payers reference PHILLIP J KEITH (M.D.)?
For PHILLIP J KEITH (M.D.), use NPI 1073802468 as the unique 10-digit identifier.
Active or inactive — what applies to PHILLIP J KEITH (M.D.)?
You should see PHILLIP J KEITH (M.D.) as active in CMS-hosted NPPES data.
How would a patient describe PHILLIP J KEITH (M.D.)'s focus?
For PHILLIP J KEITH (M.D.), the primary taxonomy reads as Dermatology Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for PHILLIP J KEITH (M.D.)?
Travel planning: use Rochester, Minnesota as the reference point for PHILLIP J KEITH (M.D.), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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