KEITH D HENRY (MD) – Emergency Medicine Physician, NPI 1417922089

KEITH D HENRY (MD) is a healthcare provider. based in Stillwater, Minnesota. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. 47419 (MN). The NPI Number for KEITH D HENRY (MD) is 1417922089

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
KEITH D HENRY (MD)
NPI
1417922089
Phone
(651) 439-5330
Address
927 Churchill St W
Enumeration Date
17 February 2006
Last Update Date
18 August 2022

Doctor Profile

Medical School Name
UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE
Secondary Phone
6512212164
Graduation Year
2002 (24 years ago)
PAC ID
1850333576
Group Practice PAC ID
3173436755
Professional Enrollment ID
I20050524000224
Address ID
MN551012502SA640XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:20State licenses:2Digital endpointsOther names

1,171 EMERGENCY MEDICINE in MN

Provider Addresses for KEITH D HENRY (MD)

  • 927 Churchill St W

    Stillwater, MN 550826605

    Phone: (651) 439-5330

    Type: Location

  • 405 Stageline Rd

    Hudson, WI 540167848

    Phone: (715) 531-6000

    Type: Location

  • 265 Griffin St E

    Amery, WI 540011439

    Phone: (715) 268-8000

    Type: Location

  • 535 Hospital Rd

    New Richmond, WI 540171449

    Phone: (715) 243-2600

    Type: Location

  • 34th Avenue South, Bloomington, Hennepin County, Minnesota, 55425, United States

    MC21110Q

    BLOOMINGTON, MN 554251672

    Phone: (952) 883-7172

    Fax: (952) 883-5395

    Type: Mailing

  • Regions Hospital, 640, Jackson Street, Saint Paul, Ramsey County, Minnesota, 55101, United States

    MC 11102F

    ST PAUL, MN 551012502

    Phone: (651) 254-3456

    Fax: (651) 254-5216

    Type: Location

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: 2008-05-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

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
I20050524000224IEmergency MedicineMNTBD
I20080513000591IEmergency MedicineWITBD

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.

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
99285Emergency department visit with high level of medical decision making144142$0
99284Emergency department visit with moderate level of medical decision making7575$0
99283Emergency department visit with low level of medical decision making4039$0
99291Critical care, first 30-74 minutes2323$0
93308Ultrasound of heart, follow-up1111$0
View full utilization report →

Insurance plans in this area (ZIP 55082)

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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: 3173436755View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MN
Emergency MedicineMN
Certified Registered Nurse Anesthetist (Crna)MN
Physical Therapist In Private PracticeMN
Occupational Therapist In Private PracticeMN
Physical Therapist In Private PracticeMN
Certified Registered Nurse Anesthetist (Crna)MN
-WI
Physical Therapist In Private PracticeMN
Certified Registered Nurse Anesthetist (Crna)CA

Reviews

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Frequently asked questions

Can I verify KEITH D HENRY (MD) with an NPI only?
You can start verification with NPI 1417922089 for KEITH D HENRY (MD), then check state licensing separately.
Is KEITH D HENRY (MD) still practicing?
KEITH D HENRY (MD) is currently listed as active in the public NPI registry.
What healthcare role does KEITH D HENRY (MD) hold?
Scheduling teams often label KEITH D HENRY (MD) under Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What area does KEITH D HENRY (MD) serve?
KEITH D HENRY (MD)'s listing highlights Stillwater, Minnesota; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.