Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Keith A Mayo, MD

Individual provider Family Medicine Physician · NPI 1922595396

Keith A Mayo, MD is a Family Practice in Glen Cove, New York. Qualified in 2017, 9 years ago. Practices with Southeastern Intensivist Services PC, a 237-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
9
Licensed in
VA
In the registry since
2018
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

101 Saint Andrews Ln
Glen Cove, NY 11542-2254
Phone: (516) 674-7631
Fax: (516) 674-7639
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 0101271494 (VA)

Record details

NPI number1922595396
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 20, 2018
Last updated in NPPESJune 18, 2021
Certification dateJune 18, 2021
Mailing address101 Saint Andrews Ln, Glen Cove, NY 11542-2254

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Southeastern Intensivist Services Pc — 237 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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