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Active NPI 1134308067 Individual Practitioner Male Practitioner

Shane A Keck , MPA, PA-C

Physician Assistant • Kirkland, WA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Shane Keck, MPA, PA-C is a certified Physician Assistant practicing in Kirkland, WA. With approximately 19 years of clinical experience since completing medical education in 2007, Shane Keck delivers high-quality medical care to the local community at 3100 CARILLON PT.

Shane Keck is affiliated with Strother Dermatology And Laser Treatment Center Pllc and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

3100 Carillon Pt

Kirkland, WA 980337306

Telephone 4255761700
Fax 4258277725
Associated Practice Facility / Clinic
🏢 Northwest Nasal Sinus Center Facility NPI 1457309312

Medicare Profile & Education

Medical School

Other

Graduation Year

2007

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Kirkland, WA

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
19 Yrs +8.5 yrs vs City Avg
City Avg: 10.5 Yrs
State Avg: 12.1 Yrs
Regional Practice Density
39 Specialists

Practicing in Kirkland, WA (3774 Statewide)

Telehealth Adoption Rate
33.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Keck (19 Years) 19 Yrs
Kirkland Specialty Average (10.5 Years) 10.5 Yrs

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License WA PA60021277

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License KS 1187

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
200536260A (KS)

Hospital & Practice Group Affiliations

Strother Dermatology And Laser Treatment Center Pllc

1231 116th Ave Ne, Bellevue, WA 980043804

Phone: 4258994144

Strother Dermatology And Laser Treatment Center Pllc

17000 140th Ave Ne, Woodinville, WA 980726928

Phone: 4258994144

Strother Dermatology And Laser Treatment Center Pllc

12911 120th Ave Ne, Kirkland, WA 980343027

Phone: 4258994144

Practice Associates & Co-Workers

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

5 Associated Practitioners
Dr. P Brundidge , MD

Anesthesiology

NPI 1366452765

Doctor of Medicine (M.D.)

Dr. Ludwig Allegra , MD

Otolaryngology - Facial Plastic Surgery

NPI 1477511889

Doctor of Medicine (M.D.)

Gary Beerman , PA-C, ARNP

Nurse Practitioner - Family

NPI 1497855308

Physician Assistant (Certified), Advanced Registered Nurse Practitioner

Dr. Sunil Ummat , MD

Otolaryngology

NPI 1982675567

Doctor of Medicine (M.D.)

Dr. Samira Ummat , MD

Physical Medicine & Rehabilitation

NPI 1982732830

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active September 04, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location September 04, 2012

Registered at 3100 CARILLON PT, KIRKLAND, WA 980337306 (Tel: 4255761700)

📍
Updated Business Mailing Address September 04, 2012

Registered at 3100 CARILLON POINT, KIRKLAND, WA 980337306 (Tel: 4255761700)

👤
Provider Name / Credentials Updated September 04, 2012

Recorded as SHANE KECK, MPA,PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 04, 2012

Physician Assistant (License #PA60021277 in WA)

🟢
Initial NPI Registration & Enumeration October 27, 2007

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: 1134308067
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 27, 2007
Last Update: September 04, 2012
Sole Proprietor: No

Mailing Address

3100 Carillon Point

Kirkland, WA 980337306

Phone: 4255761700

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.