Individual provider Active NPI

Robert Alan Kelter, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1104805936
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
170617 Issued in NY
Practice address
346 77TH St
Brooklyn, NY 11209-3110
Phone
(718) 745-1064
Fax
(718) 748-1381
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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 170617 NY Primary

Addresses

Primary practice location

346 77TH St
Brooklyn, NY 11209-3110

Mailing address

346 77TH St
Brooklyn, NY 11209-3110
Phone (718) 745-1064

Other identifiers 1

IdentifierTypeStateIssuer
01052886MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rkelter130030@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20071008000574 NY Practitioner - Internal Medicine 9234224049 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
New York University Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
Jeremiah M Gelles, MD PC Past Accepting new patients
United Medical Associates,PLLC Past Accepting new patients

Locations

8714 5th Ave
Brooklyn, NY 11209
Phone (718) 630-8600

346 77th St
Brooklyn, NY 11209
Phone (718) 745-1064

Organizations & group practices 4

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": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1104805936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 77TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093110",
            "telephone_number": "718-745-1064",
            "fax_number": "718-748-1381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 77TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093110",
            "telephone_number": "718-745-1064",
            "fax_number": "718-748-1381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELTER",
        "first_name": "ROBERT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "170617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01052886",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkelter130030@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "346 77th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112093110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.