KEENE CLINIC
NPI 1205016136
Clinic/Center - Primary Care in Keenesburg, CO
About Keene Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KEENE CLINIC (NPI 1205016136) is a healthcare organization registered as a primary care in Keenesburg, Colorado and active in the NPI registry since November 2007. The organization holds a CLIA Microscopy certificate valid through August 16, 2028 and lists Benjamin Martinez-andujo, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Keene Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Keene Clinic, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (6)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 06D0949991
Keene Clinic · Keenesburg, COFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Keene Clinic's NPI number?
The NPI number for Keene Clinic is 1205016136. It was assigned to this organization in the NPPES registry on November 8, 2007.
Where is Keene Clinic located?
Keene Clinic is located at 190 S Main Street, Keenesburg, CO 80643. The listed phone number is (303) 732-4268.
What is Keene Clinic's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Keene Clinic enrolled in Medicare?
Yes. Keene Clinic is registered in the Medicare PECOS enrollment system.
When is Keene Clinic's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Colorado, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Keene Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Keene Clinic. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (5) and Family Practice (1). Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Keene Clinic hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 06D0949991) is associated with this NPI, valid through August 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Keene Clinic was last updated on February 15, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Keene Clinic · NPI 1205016136
Primary Care organization in Keenesburg, Colorado. Organization record, active in the CMS NPPES registry since November 8, 2007.
## Identity
- **NPI:** 1205016136 (Entity type: Organization)
- **Enumerated:** November 8, 2007
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Benjamin Martinez-Andujo, CEO
## Practice location
- **Address:** 190 S MAIN STREET, Keenesburg, CO 80643-0559
- **Phone:** (303) 732-4268 · **Fax:** (303) 732-9288
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Colorado, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 6 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (5), Family Practice (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 15, 2011
- **Other identifiers:** Medicare PIN C414808 (CO)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1205016136) · Data from the CMS NPPES public registry.