Individual provider Active NPI

Sean Jeffrey Keller, MD

  • Family Medicine Physician
  • Wantagh, NY
National Provider Identifier
1013650936
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
340109-01 Issued in NY
Practice address
2840 Jerusalem Ave
Wantagh, NY 11793-2017
Phone
(516) 781-1141
Fax
(516) 781-1184
NPI assigned
Apr 18, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 340109-01 NY Primary

Addresses

Primary practice location

2840 Jerusalem Ave
Wantagh, NY 11793-2017

Mailing address

1000 Montauk Hwy
West Islip, NY 11795-4927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260116003615 NY Practitioner - Family Practice 0446609267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

1000 N Village Ave
Rockville Center, NY 11570-1000

2840 Jerusalem Ave
Wantagh, NY 11793-2017
Phone (516) 781-1141

Hospital & facility affiliations

  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286
  • Chsli St Joseph Hospital Hospital, Bethpage, NY, CCN 330332

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
340109-01NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, PC Single Specialty CurrentSince Dec 1, 2025 Accepting new patients
CHS Physician Partners, P.C Single Specialty CurrentSince Dec 1, 2025 Accepting new patients

Locations

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

2840 Jerusalem Ave
Wantagh, NY 11793
Phone (516) 781-1141

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: skeller141676@direct-chsli.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1013650936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954927",
            "fax_number": "631-376-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 JERUSALEM AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932017",
            "telephone_number": "516-781-1141",
            "fax_number": "516-781-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "SEAN",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-18",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "340109-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

Verify at the official NPI Registry.