MR. KEITH EDWARD SHULTS RPA
NPI 1770832909
Physician Assistant - Surgical in Syracuse, NY

Q: What is Keith Shults's NPI number?

The NPI number for Keith Shults is 1770832909. It was assigned to this individual provider in the NPPES registry on September 4, 2012.

Q: What is Keith Shults's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Keith Shults was last updated on May 31, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 04, 2012PECOS EnrolledAccepts Medicare Assignment

301 PROSPECT AVE, SYRACUSE, NY 13203(315) 448-5111(315) 703-5079 Get Directions Write a Review

NPPES record last updated: May 31, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Mr. Keith Edward Shults Rpa NPPES

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

MR. KEITH EDWARD SHULTS RPA (NPI 1770832909) is an individual surgical provider in Syracuse, New York and active in the NPI registry since September 2012. He is enrolled in Medicare PECOS, is affiliated with St Joseph's Hospital Health Center, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1770832909

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameMR. KEITH EDWARD SHULTSCredential: RPA

Location Address301 PROSPECT AVESyracuse, NY 13203-1807

Mailing Address104 Union Ave, Suite 804Syracuse, NY 13203-1843 · (315) 703-5049 · Fax (315) 703-5079

Phone(315) 448-5111

Fax(315) 703-5079

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateSeptember 4, 2012

Last NPPES UpdateMay 31, 2013

✔ NPI 1770832909 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

301 PROSPECT AVE, Syracuse, NY 13203

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Keith Edward Shults Rpa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2365682556

PECOS Enrollment IDI20130711000596

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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Varicose vein removal NAN08

Varicose vein removal is a procedure to eliminate enlarged and twisted veins, commonly found in legs. It's performed when these veins cause discomfort or skin problems. The procedure may involve laser treatment, sclerotherapy (injecting a solution to close the veins), or surgery to remove the veins. It's generally safe and helps to alleviate symptoms.

0 services1 patient

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Joseph's Hospital Health Center

Acute Care Hospitals · Syracuse, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330140

Location301 Prospect AvenueSyracuse, NY 13203 · Onondaga County

Emergency services Birthing friendly

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.

MRS. HAILEY L DIANA CRNA

Nurse Anesthetist, Certified Registered