Keith Kastelic, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

104154 Issued in MO

Practice address

801 E Dixie Ave
Ste 104
Leesburg, FL 34748-7699

Phone

(352) 365-2583

Fax

(352) 728-6749

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Diagnostic Radiology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake Medical Imaging and Breast Center at the Villages LLCGroup PAC ID 0042116865, 21 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.22 of 100Reported as group

Quality

95.56

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

96.5 of 100Reported as group

Quality

90

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: kkastelic563709@direct.shands.ufl.edu

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.

• Lake Medical Imaging and Breast Center at the Villages LLC

  • Diagnostic Radiology Physician
  • Leesburg, FL
  • NPI 1770541633
  Medicare reassignment Care Compare group NPD
• Radiology Associates of Central Florida L L C

  • Diagnostic Radiology Physician
  • Leesburg, FL
  • NPI 1184689127
  Medicare reassignment NPD
• Lake Medical Imaging and Breast Center at the Villages LLC

  • Diagnostic Radiology Physician
  • The Villages, FL
  • NPI 1366015232
  NPD (past)
• Lake Medical Imaging and Breast Center at the Villages LLC

  • Diagnostic Radiology Physician
  • The Villages, FL
  • NPI 1659940807
  NPD (past)
• Lake Medical Imaging and Breast Center at the Villages LLC

  • Diagnostic Radiology Physician
  • The Villages, FL
  • NPI 1912570045
  NPD (past)
• Lake Medical Imaging and Breast Center at the Villages LLC

  • Diagnostic Radiology Physician
  • The Villages, FL
  • NPI 1942879192
  NPD (past)
• Columbia Radiology, LTD

  • Diagnostic Radiology Physician
  • Columbia, MO
  • NPI 1932200169
  NPD (past)
• Radiology Fond Du Lac LTD

  • Diagnostic Radiology Physician
  • Fond Du Lac, WI
  • NPI 1134191687
  NPD (past)
• Scott Radiological Group Inc

  • Diagnostic Radiology Physician
  • Festus, MO
  • NPI 1063445096
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1053405381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 N 3RD ST",
            "address_2": "STE 115",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485285",
            "telephone_number": "352-365-2583",
            "fax_number": "352-728-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E DIXIE AVE",
            "address_2": "STE 104",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487699",
            "telephone_number": "352-365-2583",
            "fax_number": "352-728-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASTELIC",
        "first_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "104154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Kachmar, RPH
• George Edward Kainz, M.D.
• Desiree A Kalarovich, RN
• Ana Karovska Vuchidolov, M.D.
• Gina Kasprick
• Patricia Ann Kauffman, LPN
• Cathrine Elena Keller, M.D.
• Kilee J Kelly Sleeper, MSW, LCSW
• John Edward Kelly, PA
• Gloria Jean Kennedy, LPN

• Diagnostic Radiology Physician in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.