Dr Keith David Clancy, MD - Medicare General Surgery in Fort Wayne, IN

Dr Keith David Clancy, MD is a medicare enrolled "Surgery - Trauma Surgery" physician in Fort Wayne, Indiana. He went to Creighton University School Of Medicine and graduated in 1992 and has 32 years of diverse experience with area of expertise as General Surgery. He is a member of the group practice Florida Trauma Services Llc and his current practice location is 7900 W Jefferson Blvd Ste 306, Fort Wayne, Indiana. You can reach out to his office (for appointments etc.) via phone at (260) 458-3610.

Dr Keith David Clancy is licensed to practice in Indiana (license number 01079569A) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1164482303.

Contact Information

Dr Keith David Clancy, MD
7900 W Jefferson Blvd Ste 306,
Fort Wayne, IN 46804-4128
(260) 458-3610
(260) 458-3611



Physician's Profile

Full NameDr Keith David Clancy
GenderMale
SpecialityGeneral Surgery
Experience32 Years
Location7900 W Jefferson Blvd Ste 306, Fort Wayne, Indiana
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Keith David Clancy attended and graduated from Creighton University School Of Medicine in 1992
  NPI Data:
  • NPI Number: 1164482303
  • Provider Enumeration Date: 03/23/2006
  • Last Update Date: 09/23/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 7012947039
  • Enrollment ID: I20230720000008

Medical Identifiers

Medical identifiers for Dr Keith David Clancy such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1164482303NPI-NPPES
001757641MedicaidPA
117558OtherPAUNISON-WMG
562564OtherPAHIGHMARK BLUE SHIELD
039983OtherPAJOHNS HOPKINS
20006031OtherPAAMERIHEALTH MERCY-WMG
7731206OtherPAAETNA
01122002OtherPACAPITAL BLUE CROSS-WMG
491516OtherPAMAMSI-WMG
610201OtherMDCAREFIRST MD BCBS
1506063OtherPAGATEWAY-WMG
56845OtherPAGEISINGER
0342984000OtherPAAMERIHEALTH 65 PA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208600000XSurgery MD067578-L (Pennsylvania)Secondary
208600000XSurgery 036.090092 (Illinois)Secondary
208600000XSurgery 35.123491 (Ohio)Secondary
208600000XSurgery 01079569A (Indiana)Secondary
2086S0102XSurgery - Surgical Critical Care MD067578-L (Pennsylvania)Secondary
2086S0102XSurgery - Surgical Critical Care 35.123491 (Ohio)Secondary
2086S0127XSurgery - Trauma Surgery 036.090092 (Illinois)Secondary
2086S0127XSurgery - Trauma Surgery MD067578-L (Pennsylvania)Secondary
2086S0127XSurgery - Trauma Surgery 35.123491 (Ohio)Secondary
2086S0127XSurgery - Trauma Surgery 01079569A (Indiana)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Orange Park Medical CenterOrange park, FLHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Florida Trauma Services Llc397198593885

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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. Dr Keith David Clancy allows following entities to bill medicare on his behalf.
Entity NameFlorida Trauma Services Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1477296952
PECOS PAC ID: 3971985938
Enrollment ID: O20220808001578

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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. Dr Keith David Clancy 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
Dr Keith David Clancy, MD
6920 Pointe Inverness Way Ste 200,
Fort Wayne, IN 46804-7934

Ph: (260) 479-3514
Dr Keith David Clancy, MD
7900 W Jefferson Blvd Ste 306,
Fort Wayne, IN 46804-4128

Ph: (260) 458-3610

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Surgery Doctors in Fort Wayne, IN

Dr. Ian H. Cook, M.D.
Surgery
Medicare: Medicare Enrolled
Practice Location: 2121 Lake Ave, Veterans Affairs Medical Center, Fort Wayne, IN 46805
Phone: 260-426-5431    
Brett J. Guinn, MD
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 2510 E Dupont Rd Ste 210, Fort Wayne, IN 46825
Phone: 260-458-3710    Fax: 260-458-3714
Dr. Paul Mitchell Bauer, MD
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: Lutheran Hospital, 7950 W Jefferson Blvd, Fort Wayne, IN 46804
Phone: 260-435-7001    
Lindsay B Hardley, D.O.
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 11050 Parkview Circle Dr, Fort Wayne, IN 46845
Phone: 833-724-8326    Fax: 260-425-6845
Dr. Charles Michael Morgan, MD
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 7950 W Jefferson Blvd, Fort Wayne, IN 46804
Phone: 260-432-2297    Fax: 260-434-6481
Jeffery A Yoder, MD
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 11141 Parkview Plaza Dr Ste 305, Fort Wayne, IN 46845
Phone: 260-484-9611    Fax: 260-484-1004

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