Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Keegan J White, PA-C

Individual provider Surgical Physician Assistant · NPI 1093445744

Keegan J White, PA-C is a Physician Assistant in New York, New York. Qualified in 2022, 4 years ago. Practices with Ny Society for the Relief of Ruptured and Crippled Maintaining, a 175-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2022
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

5141 Broadway
New York, NY 10034-1159
Phone: (585) 953-7296
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X

Record details

NPI number1093445744
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 15, 2022
Last updated in NPPESJune 15, 2022
Certification dateJune 15, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Ny Society For The Relief Of Ruptured And Crippled Maintaining — 175 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Ny Society for the Relief of Ruptured and Crippled Maintaining

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 175 clinicians in the practice; 12 are shown here.

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