Individual provider Active NPI

Kyle Anthony Keller, MD

  • Family Medicine Physician
  • Maumee, OH
National Provider Identifier
1083176622
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.144587 Issued in OH
Practice address
1657 Holland Rd Ste a
Maumee, OH 43537-1661
Phone
(419) 794-2180
Fax
(419) 794-2180
NPI assigned
Apr 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 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 Physician 207Q00000X 35.144587 OH Primary

Addresses

Primary practice location

1657 Holland Rd Ste a
Maumee, OH 43537-1661

Mailing address

1657 Holland Rd Ste a
Maumee, OH 43537-1661

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220720000491 OH Practitioner - Family Practice 9537540752 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Toledo College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians-North LLCGroup PAC ID 2668522400, 131 clinicians
Central Ohio Primary Care Physicians, Inc.Group PAC ID 2769383785, 487 clinicians

Practice addresses (Care Compare)

1657 Holland Rd
Suite a
Maumee, OH 43537-1661
Phone (419) 794-2180

5130 Bradenton Ave
Suite a
Dublin, OH 43017-7068
Phone (614) 734-1100

Hospital & facility affiliations

  • Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112
  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.144587OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians - North, LLC CurrentSince Oct 13, 2025 Accepting new patients
Central Ohio Primary Care Physicians, Inc. Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients
Central Ohio Primary Care Physicians, Inc. CurrentSince Aug 1, 2022 Accepting new patients
Mercy Health Physicians-North LLC Family Medicine CurrentSince Oct 13, 2025 Accepting new patients
Mercy Health System Northern Past Accepting new patients

Locations

4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665

5130 Bradenton Ave
Ste A
Dublin, OH 43017
Phone (614) 734-1100

1657 Holland Rd
Ste A
Maumee, OH 43537
Phone (419) 794-2180

5705 Monclova Rd
Ste 100
Maumee, OH 43537
Phone (419) 794-2180

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

655 Africa Rd
Westerville, OH 43082

Interoperability endpoints

  • Direct secure messaging: kkeller18784@copcp.medicity.net
  • Direct secure messaging: kkeller3044713@direct.bsmhealth.org

Organizations & group practices 6

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": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1083176622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1657 HOLLAND RD STE A",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1657 HOLLAND RD STE A",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371661",
            "telephone_number": "419-794-2180",
            "fax_number": "419-794-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "KYLE",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.144587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

Verify at the official NPI Registry.