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Keith Y. M. Cheng

Psychiatry & Neurology

Allopathic & Osteopathic Physicians

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

PECOS Enrollment

This provider is enrolled in PECOS as KEITH CHENG.

Based on the most recent information from CMS, provider Keith Y. M. Cheng is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1306854849
Provider Type
Individual
Full Name
Cheng, Keith Y. M.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
8/3/2006
Last Updated
2/11/2016

Contact Information

Practice Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

(503) 494-8617

Unlisted Fax

Mailing Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

(503) 494-8617

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2084P0800X Primary	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License MD16582 Oregon

Provider Identifiers

ID	Description	Issuer
ID 010152	Description Medicaid	Issuer Unlisted Oregon

Keith Y. M. Cheng

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Kesserwani, Christie

Emens, Jonathan Scott

Marx, Charlotte Alexandra

Yaeger, Deborah

Yousuf, Sameer Syed

Schmick, Elizabeth Ann

Barrett, Thomas Beach

Kennedy, Donald Louis

Allahyar, Arrash

Boverman, Joshua Findley