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

Mr. Keith Edward Shults, RPA

Individual provider Surgical Physician Assistant · NPI 1770832909

Mr. Keith Edward Shults, RPA is a Physician Assistant in Syracuse, New York. Qualified in 2012, 14 years ago. Practices with St Josephs Medical PC, a 385-clinician group and accepts Medicare assignment.

Years since qualifying
14
In the registry since
2012
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Practice location Address checks out

301 Prospect Ave
Syracuse, NY 13203-1807
Phone: (315) 448-5111
Fax: (315) 703-5079
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X

Record details

NPI number1770832909
Entity typeIndividual (Type 1)
GenderMale
Credentials RPA
Sole proprietorNo
NPI enumeratedSeptember 4, 2012
Last updated in NPPESMay 31, 2013

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice St Josephs Medical Pc — 385 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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