Individual provider Active NPI

Daniel Ryan Keller, DPT

  • Physical Therapist
  • Menlo Park, CA
National Provider Identifier
1083029326
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 41875 Issued in CA
Practice address
3550 Alameda de Las Pulgas
Menlo Park, CA 94025-6559
Phone
(650) 926-9413
NPI assigned
Jun 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 41875 CA Primary

Addresses

Primary practice location

3550 Alameda de Las Pulgas
Menlo Park, CA 94025-6559

Mailing address

17 Francisca Dr
Moraga, CA 94556-1583
Phone (916) 214-9280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150119000762 CA Practitioner - Physical Therapist in Private Practice 4789908930 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41875CAMDMarriage & Family Therapist
PT 41875CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Barman & Sargent Inc Physical Therapist CurrentSince Nov 3, 2014 Accepting new patients

Locations

315 Diablo Rd
Ste 110
Danville, CA 94526
Phone (925) 855-8343

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": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1083029326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 FRANCISCA DR",
            "city": "MORAGA",
            "state": "CA",
            "postal_code": "945561583",
            "telephone_number": "916-214-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 ALAMEDA DE LAS PULGAS",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940256559",
            "telephone_number": "650-926-9413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "DANIEL",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-25",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 41875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.