MARY KEOUGH
NPI 1235785239
Physical Medicine & Rehabilitation - Sports Medicine in East Providence, RI
About Mary Keough NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY KEOUGH (NPI 1235785239) is an individual sports medicine provider in East Providence, Rhode Island, licensed in Rhode Island (PT03193) and active in the NPI registry since August 2019.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mary Keough is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mary Keough reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
North Smithfield, RI 02896
- Reassigned Medicare billing, Rhode Island enrollment
- 3 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently 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 Mary Keough's NPI number?
The NPI number for Mary Keough is 1235785239. It was assigned to this individual provider in the NPPES registry on August 15, 2019.
Where is Mary Keough located?
Mary Keough practices at 33 Veterans Memorial Pkwy, East Providence, RI 02914. The listed phone number is (401) 429-6290.
What is Mary Keough's specialty?
The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Sports Medicine, with taxonomy code 2081S0010X.
Is Mary Keough enrolled in Medicare?
Yes. Mary Keough is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mary Keough's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Keough reassigns Medicare benefits to Matrix Sports Medicine & Physical Therapy Inc (North Smithfield, RI). The 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 Mary Keough's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mary Keough was last updated on July 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.
# Mary Keough · NPI 1235785239
Sports Medicine physician in East Providence, Rhode Island. Individual provider, active in the CMS NPPES registry since August 15, 2019.
## Identity
- **NPI:** 1235785239 (Entity type: Individual)
- **Enumerated:** August 15, 2019
- **Primary specialty:** Physical Medicine & Rehabilitation - Sports Medicine · taxonomy 2081S0010X
- **State license:** PT03193 (Rhode Island)
- **Sole proprietor:** No
## Practice location
- **Address:** 33 VETERANS MEMORIAL PKWY, East Providence, RI 02914-5017
- **Phone:** (401) 429-6290
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Matrix Sports Medicine & Physical Therapy Inc (NPI 1205894532, North Smithfield, RI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 26, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1235785239) · Data from the CMS NPPES public registry.