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Active NPI 1164482303 Individual Practitioner Male Practitioner

Dr. Keith David Clancy , MD

Surgery - Trauma Surgery • Fort Wayne, IN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Keith Clancy, MD is a certified Surgery - Trauma Surgery practicing in Fort Wayne, IN. With approximately 34 years of clinical experience since graduating from Creighton University School Of Medicine in 1992, Dr. Clancy delivers high-quality medical care to the local community at 7900 W JEFFERSON BLVD STE 306.

Dr. Clancy is affiliated with Florida Trauma Services Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include subsequent hospital care with moderate levelof medical decision making, if using time, at least, hospital discharge day management, initial hospital care with straightforward or low-level medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

7900 W Jefferson Blvd Ste 306

Fort Wayne, IN 468044128

Telephone 2604583610
Fax 2604583611

Medicare Profile & Education

Medical School

Creighton University School Of Medicine

Graduation Year

1992

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery - Trauma Surgery in Fort Wayne, IN

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
34 Yrs +12.6 yrs vs City Avg
City Avg: 21.4 Yrs
State Avg: 25.1 Yrs
Regional Practice Density
9 Specialists

Practicing in Fort Wayne, IN (17 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
82.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Clancy (34 Years) 34 Yrs
Fort Wayne Specialty Average (21.4 Years) 21.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes
154 93 $398.00 $76.87
99238 Hospital discharge day management, 30 minutes or less
67 67 $406.00 $78.72
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes
56 56 $757.00 $128.20
99231 Follow-up hospital inpatient care per day, typically 15 minutes
56 42 $217.00 $48.67
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes
35 20 $572.00 $115.19
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes
27 27 $1107.00 $168.90
99221 Initial hospital inpatient care per day, typically 30 minutes
12 12 $564.00 $81.95

Medical Specialties & State Licenses

CMS Verified: 2020-09-23
Surgery - Trauma Surgery Primary Specialty

NUCC Taxonomy Code: 2086S0127X

State License IN 01079569A

Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency.

Surgery

NUCC Taxonomy Code: 208600000X

State License IL 036.090092

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Surgery

NUCC Taxonomy Code: 208600000X

State License OH 35.123491

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Surgery

NUCC Taxonomy Code: 208600000X

State License IN 01079569A

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Surgery - Surgical Critical Care

NUCC Taxonomy Code: 2086S0102X

State License PA MD067578-L

A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

Surgery

NUCC Taxonomy Code: 208600000X

State License PA MD067578-L

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Surgery - Trauma Surgery

NUCC Taxonomy Code: 2086S0127X

State License IL 036.090092

Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency.

Surgery - Trauma Surgery

NUCC Taxonomy Code: 2086S0127X

State License PA MD067578-L

Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency.

Surgery - Trauma Surgery

NUCC Taxonomy Code: 2086S0127X

State License OH 35.123491

Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency.

Surgery - Surgical Critical Care

NUCC Taxonomy Code: 2086S0102X

State License OH 35.123491

A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
001757641 (PA)
Commercial Insurance / Payer ID Unison-Wmg
117558 (PA)
Commercial Insurance / Payer ID Highmark Blue Shield
562564 (PA)
Commercial Insurance / Payer ID Johns Hopkins
039983 (PA)
Commercial Insurance / Payer ID Amerihealth Mercy-Wmg
20006031 (PA)
Commercial Insurance / Payer ID Aetna
7731206 (PA)
Commercial Insurance / Payer ID Capital Blue Cross-Wmg
01122002 (PA)
Commercial Insurance / Payer ID Mamsi-Wmg
491516 (PA)
Commercial Insurance / Payer ID Carefirst Md Bcbs
610201 (MD)
Commercial Insurance / Payer ID Gateway-Wmg
1506063 (PA)

Hospital & Practice Group Affiliations

Florida Trauma Services Llc

1887 Kingsley Ave, Orange Park, FL 320734451

Phone: 9042762549

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

18 Associated Practitioners
Victoria Vamos , PA-C

Physician Assistant

NPI 1083311435

Physician Assistant (Certified)

Geoffrey Mccord , NP

Nurse Practitioner - Family

NPI 1124302633

Nurse Practitioner

Karsten Cooper , PA-C

Physician Assistant

NPI 1124698311

Physician Assistant (Certified)

Milissa Phillips-Bohlender , NP

Nurse Practitioner - Family

NPI 1164474045

Nurse Practitioner

Dr. Tianli Du , MD

Surgery - Trauma Surgery

NPI 1205217148

Doctor of Medicine (M.D.)

Dr. Constantine Saites , MD, MS

Surgery - Trauma Surgery

NPI 1306098439

Doctor of Medicine (M.D.), Master of Science

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
📍
Updated Business Mailing Address September 23, 2020

Registered at 6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 468047934 (Tel: 2604793514)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 23, 2020

Surgery (License #MD067578-L in PA)

📍
Updated Practice Location September 13, 2018

Registered at 7900 W JEFFERSON BLVD STE 306, FORT WAYNE, IN 468044128 (Tel: 2604583610)

NPI Profile Active October 18, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location October 18, 2017

Registered at 1000 E MOUNTAIN BLVD, WILKES BARRE, PA 187110027 (Tel: 5708082340)

📍
Updated Business Mailing Address October 18, 2017

Registered at 100 N ACADEMY AVE, DANVILLE, PA 178224903 (Tel: 5702716144)

👤
Provider Name / Credentials Updated October 18, 2017

Recorded as KEITH CLANCY, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 18, 2017

Surgery (License #35.123491 in OH)

NPI Profile Active January 04, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location January 04, 2017

Registered at 1000 E MOUNTAIN BLVD, WILKES BARRE, PA 187110027 (Tel: 5708082340)

📍
Updated Business Mailing Address January 04, 2017

Registered at 100 N ACADEMY AVE, DANVILLE, PA 178224903 (Tel: 5702716144)

👤
Provider Name / Credentials Updated January 04, 2017

Recorded as KEITH CLANCY, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 04, 2017

Surgery (License #35.123491 in OH)

🟢
Initial NPI Registration & Enumeration March 23, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164482303
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 23, 2006
Last Update: September 23, 2020
Sole Proprietor: No

Mailing Address

6920 Pointe Inverness Way Ste 200

Fort Wayne, IN 468047934

Phone: 2604793514

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.