Individual provider Active NPI

William B Keller, OD

  • Optometrist
  • Hudson, OH
National Provider Identifier
1053495010
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4292/T065 Issued in OH
Practice address
126 W Streetsboro St
Hudson, OH 44236-2720
Phone
(330) 653-8500
Fax
(330) 650-0085
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4292/T065 OH Primary

Addresses

Primary practice location

126 W Streetsboro St
Hudson, OH 44236-2720

Mailing address

126 W Streetsboro St
Hudson, OH 44236-2720
Phone (330) 653-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120209000534 OH Practitioner - Optometry 5799683082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Ohio Eye Consultants, IncGroup PAC ID 3577537810, 40 clinicians

Practice addresses (Care Compare)

2740 Carnegie Ave
Cleveland, OH 44115-2627
Phone (216) 621-6132

Merit-based Incentive Payment System (MIPS)

Final score
83.55 of 100Reported as group
Quality
81.19
Promoting interoperability
83
Improvement activities
40
Cost
78.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4292/T065OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Ohio Eye Consultants Inc Optometrist CurrentSince Sep 2, 2021 Accepting new patients
Northern Ohio Eye Consultants Inc CurrentSince Sep 2, 2021 Accepting new patients

Locations

6880 W Snowville Rd
Ste 215
Brecksville, OH 44141
Phone (440) 526-1974

2740 Carnegie Ave
Cleveland, OH 44115
Phone (216) 621-6132

130 W Streetsboro St
Hudson, OH 44236
Phone (330) 653-8500

Interoperability endpoints

  • Direct secure messaging: william.keller@direct.revolutionehr.com
  • Direct secure messaging: wkeller@clevelandeyeclinic.intellechartdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053495010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 W STREETSBORO ST",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442362720",
            "telephone_number": "330-653-8500",
            "fax_number": "330-650-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 W STREETSBORO ST",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442362720",
            "telephone_number": "330-653-8500",
            "fax_number": "330-650-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "WILLIAM",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4292/T065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, OH

Sources for this page

Verify at the official NPI Registry.