DR. KEITH A MICETICH MD
NPI 1427026137
Specialist in Jackson, TN

Active since March 09, 2006PECOS Enrolled
72 PHYSICIANS DR, JACKSON, TN 38305(731) 668-4455(731) 668-9007 Get Directions Write a Review

NPPES record last updated: November 2, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Individual
  • Male
  • Specialist
  • PECOS Enrolled

About KEITH MICETICH

This page provides the complete NPI Profile along with additional information for Keith Micetich, a provider established in Jackson, Tennessee with a medical specialization in Specialist. The healthcare provider is registered in the NPI registry with number 1427026137 assigned on March 2006. The practitioner's primary taxonomy code is 174400000X with license number 26274 (TN). The provider is registered as an individual and his NPI record was last updated 15 years ago.

NPI
1427026137 Verify this NPI
Provider Name
DR. KEITH A MICETICH MD
Gender
Male
Entity Type
Individual
Location Address
72 PHYSICIANS DR JACKSON, TN 38305
Location Phone
(731) 668-4455
Location Fax
(731) 668-9007
Mailing Address
72 PHYSICIANS DR JACKSON, TN 38305
Mailing Phone
(731) 668-4455
Mailing Fax
(731) 664-4508
Is Sole Proprietor?
No
Enumeration Date
03-09-2006
Last Update Date
11-02-2011
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
26274
License State
TN
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
3091718MEDICARE ID-TYPE UNSPECIFIED (04)TN 
3009628OTHER (01)TNBLUE CROSS BLUE SHIELD
G16712MEDICARE UPIN (02)TN 

Medicare Participation & PECOS Enrollment Status

Keith Micetich is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Cervical or vaginal cancer screening; pelvic and clinical breast examination

This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.

This service was performed 55 times for 55 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 73 times for 49 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 86 times for 72 patients

Screening mammography

Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.

This service was performed 41 times for 41 patients

Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory

A Papanicolaou smear, often called a Pap smear, is a test to check for changes in cells. A small sample is gently collected from the lower region and sent to a lab for examination. This helps in early detection of potential health issues.

This service was performed 26 times for 26 patients

Reviews for DR. KEITH A MICETICH MD

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Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
72 PHYSICIANS DR
JACKSON, TN 38305
Advanced Practice Midwife
72 PHYSICIANS DR
JACKSON, TN 38305
Obstetrics & Gynecology
72 PHYSICIANS DR
JACKSON, TN 38305

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1427026137, enumerated as an "individual" on March 09, 2006.

The provider is located at 72 PHYSICIANS DR JACKSON, TN 38305 and the phone number is (731) 668-4455.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.