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NPISignal

Individual Healthcare Provider

Keith Andrew Thatch, MD

NPI Record: ActiveSurgery — Pediatric Surgery
NPI1053577742
St Petersburg, Florida

Provider's NPPES record last updated: August 20, 2024

Overview

Entity Type
Individual Healthcare Provider
NPI
1053577742
Primary Specialty
Surgery — Pediatric Surgery
Practice Location
St Petersburg, Florida
Sole Proprietor
No

Federal Screening

NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.

List of Excluded Individuals/Entities (LEIE)

HHS Office of Inspector General

No potential match identified

No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.

Source data
September 10, 2026
Records indexed
84,001
Screened
Sep 19, 2026, 4:11 PM UTC

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

SAM.gov Exclusions

U.S. General Services Administration

Not checked

SAM.gov Exclusions was not checked.

SAM.gov screening is not configured on this deployment. No SAM check has been performed.

Screened
Not checked

This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

Run a name-based screening

Searches OIG LEIE and SAM.gov by name and reviews every potential match.

Specialties & Taxonomies

  • Surgery

    Pediatric Surgery

    Allopathic & Osteopathic Physicians

    Primary

    A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

    Taxonomy code 2086S0120X

Provider-Reported License Information

Surgery (Florida)
ME134648
Surgery (Idaho)
M-15720
Surgery (Virginia)
0101280591
License numbers are reported by the provider to NPPES and are not independently verified by NPISignal against any state licensing board. Confirm current license status directly with the issuing state board.

Practice Locations

Practice Location

601 5th St S Ste 306

St Petersburg, Florida 33701-4804

Phone: (727) 767-3439

Additional Practice Location

1000 E Broad St

Richmond, Virginia 23219-1930

Phone: (804) 828-3500

Fax: (804) 628-4501

Additional Practice Location

16230 Summerlin Rd Ste 215

Fort Myers, Florida 33908-5769

Phone: (239) 343-6050

Fax: (239) 343-9909

Additional Practice Location

305 E Jefferson St

Boise, Idaho 83712-6231

Phone: (208) 381-7370

Additional Practice Location

1072 N Liberty St Ste 200

Boise, Idaho 83704-8963

Phone: (208) 302-4600

Fax: (208) 302-4655

Record Information

Enumeration Date
August 1, 2008
Provider's NPPES Record Last Updated
August 20, 2024
Certification Date
August 20, 2024
NPISignal NPPES Dataset
August 2026

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