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DR. KEITH Y MIYAMOTO M.D.
NPI 1609883842
Urology in Gaylord, MI

Active since August 01, 2006PECOS Enrolled
829 N CENTER AVE, SUITE 160, GAYLORD, MI 49735(989) 731-7131(989) 731-6415 Get Directions Write a Review

NPPES record last updated: December 23, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Keith Y Miyamoto M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KEITH Y MIYAMOTO M.D. (NPI 1609883842) is an individual urology provider in Gaylord, Michigan, licensed in Michigan (4301032171) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609883842
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameDR. KEITH Y MIYAMOTOCredential: M.D.
Location Address829 N CENTER AVE, SUITE 160Gaylord, MI 49735-1595
Mailing Address829 N Center Ave, Suite 298Gaylord, MI 49735-1595 · (989) 731-7708 · Fax (989) 731-7929
Phone(989) 731-7131
Fax(989) 731-6415
Sole ProprietorNo
Enumeration DateAugust 1, 2006
Last NPPES UpdateDecember 23, 2020
NPPES CertifiedDecember 23, 2020
✔ NPI 1609883842 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License✔ Licensed in MI · 4301032171
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
829 N CENTER AVE, Gaylord, MI 49735
Open in Google Maps ↗

Other Identifiers 1

OtherOF96004Medicare Group Number

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Keith Y Miyamoto M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Keith Miyamoto reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Munson Healthcare Otsego Memorial Hospital
2.4 mi
Rural Health
1996 WALDEN DR
Gaylord, MI 49735
  • Reassigned Medicare billing, Michigan enrollment
  • 168 clinicians in this Medicare group
NPI 1093911364 (989) 731-4111

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49735 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Lubricant, individual sterile packet, each A4332
DME-Medical/Surgical Supplies · category DA000N
2 suppliers39 claims6,930 services$0.11 avg. paid by Medicare
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351
DME-Orthotic Devices · category DF008N
6 suppliers72 claims12,950 services$1.73 avg. paid by Medicare
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352
DME-Orthotic Devices · category DF008N
4 suppliers13 claims3,420 services$5.22 avg. paid by Medicare
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each A4358
DME-Orthotic Devices · category DF000N
4 suppliers14 claims52 services$5.21 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOHN DAVID MOFFAT M.D.
Surgery
829 N CENTER AVE, SUITE 120
GAYLORD, MI 49735
Otsego County (989) 731-7987
STEVEN JOHN WISNIEWSKI M.D.
Internal Medicine
829 N CENTER AVE, SUITE 140
GAYLORD, MI 49735
Otsego County (989) 731-7870
DR. CHANGXIN LI M.D.
Internal Medicine
829 N CENTER AVE, SUITE 140
GAYLORD, MI 49735
Otsego County (989) 731-7870
MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL
Clinic/Center (Rural Health)
829 N CENTER AVE
GAYLORD, MI 49735
Otsego County (989) 731-7708
KATHLEEN MARIE PAWLANTA F.N.P.
Nurse Practitioner (Family)
829 N CENTER AVE, SUITE 210
GAYLORD, MI 49735
Otsego County (989) 731-7860
JOHN MATTHEW LAWRENCE
Physician Assistant
829 N CENTER AVE, SUITE 210
GAYLORD, MI 49735
Otsego County (989) 731-7860
GAYLORD OBSTETRICS & GYNECOLOGY. P.C.
Obstetrics & Gynecology
829 N CENTER AVE, SUITE 200
GAYLORD, MI 49735
Otsego County (989) 731-2105
MATTHEW A MAZUR D.O.
Internal Medicine
829 N CENTER AVE, SUITE 140
GAYLORD, MI 49735
Otsego County (989) 731-7870

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 Keith Miyamoto's NPI number?

The NPI number for Keith Miyamoto is 1609883842. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Where is Keith Miyamoto located?

Keith Miyamoto practices at 829 N Center Ave Suite 160, Gaylord, MI 49735. The listed phone number is (989) 731-7131.

What is Keith Miyamoto's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Keith Miyamoto enrolled in Medicare?

Yes. Keith Miyamoto is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Keith Miyamoto's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Keith Miyamoto reassigns Medicare benefits to Munson Healthcare Otsego Memorial Hospital (Gaylord, MI). 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 Keith Miyamoto'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 Keith Miyamoto was last updated on December 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.