Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Dr. Keith David Clancy, MD

Individual provider Surgery Physician · NPI 1164482303

Dr. Keith David Clancy, MD practises General Surgery in Fort Wayne, Indiana. Graduated from Creighton University School of Medicine in 1992, 34 years ago. Practices with Florida Trauma Services LLC, a 93-clinician group and accepts Medicare assignment. Licensed in Illinois, Indiana, Ohio and Pennsylvania.

Years since qualifying
34
Trained at
Creighton University School of Medicine
Licensed in
IL, IN, OH, PA
In the registry since
2006
Specialties on file
10
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

7900 W Jefferson Blvd Ste 306
Fort Wayne, IN 46804-4128
Phone: (260) 458-3610
Fax: (260) 458-3611
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Trauma Surgery Physician (primary) Taxonomy 2086S0127X · Licence 01079569A (IN)
Surgery Physician Taxonomy 208600000X · Licence MD067578-L (PA)
Surgery Physician Taxonomy 208600000X · Licence 036.090092 (IL)
Surgery Physician Taxonomy 208600000X · Licence 35.123491 (OH)
Surgery Physician Taxonomy 208600000X · Licence 01079569A (IN)
Surgical Critical Care Physician Taxonomy 2086S0102X · Licence MD067578-L (PA)
Surgical Critical Care Physician Taxonomy 2086S0102X · Licence 35.123491 (OH)
Trauma Surgery Physician Taxonomy 2086S0127X · Licence 036.090092 (IL)
Trauma Surgery Physician Taxonomy 2086S0127X · Licence MD067578-L (PA)
Trauma Surgery Physician Taxonomy 2086S0127X · Licence 35.123491 (OH)

Record details

NPI number1164482303
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 23, 2006
Last updated in NPPESSeptember 23, 2020
Certification dateSeptember 23, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolCREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 1992 (34 years in practice)
Group practice Florida Trauma Services Llc — 93 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients247
Services billed 450 a service is one billed item, such as a visit, a test or a procedure
Average patient age79

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Payments from drug and device companies, 2025

Drug and device makers are required by federal law (the Physician Payments Sunshine Act) to report what they pay or give to clinicians, and CMS publishes the reports as Open Payments. This is the 2025 program year. A report is a record of a payment, not an allegation of anything, and many are small items such as meals. Only general payments are listed here; research payments and ownership or investment interests are reported separately by CMS and are not shown.

Food and Beverage $67 1 payment · a meal or drink at a meeting or visit, not a fee

Each amount is the sum of what companies reported for that kind of payment in 2025, rounded to the dollar. Not all of it is income to the clinician: a meal is not a fee, a charitable contribution goes to a charity, and a royalty or an acquisition payment is not a salary.

Check a report, or dispute one, at the source in CMS’s own tool, Open Payments. Corrections go through CMS’s dispute process. This site removes a home address on request and asks for no proof, because that is privacy; it will not remove an accurate payment report on request, because that is a statutory public disclosure.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

  • Baptist Health Medical Center - Jacksonville Hospital · Jacksonville, FL · listed as Dastagir a Khan MD, PA
  • Hca Florida Lake City Hospital Hospital · Lake City, FL
  • Hca Florida Orange Park Hospital Hospital · Orange Park, FL

Colleagues at Florida Trauma Services LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 93 clinicians in the practice; 12 are shown here.

Other providers in Fort Wayne