NPIMap

Individual provider Active NPI

Thomas C Keller Jr., D.O.

  • Internal Medicine Physician
  • Hanover, PA
National Provider Identifier
1073587515
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS013037 Issued in PA
Practice address
250 Fame Ave
Suite 135
Hanover, PA 17331-1587
Phone
(717) 632-3235
Fax
(717) 632-7292
NPI assigned
Feb 13, 2006
Last updated
Jul 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS013037 PA Primary

Addresses

Primary practice location

250 Fame Ave
Suite 135
Hanover, PA 17331-1587

Mailing address

250 Fame Ave
Suite 135
Hanover, PA 17331-1587
Phone (717) 632-3235

Other identifiers 1

IdentifierTypeStateIssuer
1010925380001MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040821000000 PA Practitioner - Internal Medicine 1951375484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia School of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Hillside Internal Medicine PCGroup PAC ID 2365434198, 3 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

250 Fame Ave
Suite 135
Hanover, PA 17331-1576
Phone (717) 632-3235

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.88 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS013037PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hillside Internal Medicine PC Internal Medicine CurrentSince Sep 1, 2004 Accepting new patients
Spiritrust Lutheran Past Accepting new patients
The Brethren Home Community Past Accepting new patients
Homewood Living Plum Creek, Inc Past Accepting new patients
Spiritrust Lutheran Past Accepting new patients
Hanover Opco LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

250 Fame Ave
Ste 135
Hanover, PA 17331
Phone (717) 632-3235

250 Fame Ave
Ste 201
Hanover, PA 17331
Phone (717) 633-9086

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Spiritrust Lutheran the Village at GettysburgGettysburg, PA, CCN 395647 Skilled nursing facility Adp of the SNF Jan 1, 2024
Cross Keys VillageNew Oxford, PA, CCN 395108 Skilled nursing facility Adp of the SNF Mar 20, 2025
Spiritrust Lutheran the Village at Utz TerraceHanover, PA, CCN 396111 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 1, 2025
Nov 1, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1073587515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 FAME AVE",
            "address_2": "SUITE 135",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173311587",
            "telephone_number": "717-632-3235",
            "fax_number": "717-632-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 FAME AVE",
            "address_2": "SUITE 135",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173311587",
            "telephone_number": "717-632-3235",
            "fax_number": "717-632-7292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "THOMAS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS013037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010925380001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, PA

Sources for this page

Verify at the official NPI Registry.