Individual provider Active NPI

Cathrine Elena Keller, M.D.

  • Diagnostic Radiology Physician
  • Leesburg, FL
National Provider Identifier
1104874288
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME51560 Issued in FL
Practice address
801 E Dixie Ave
Suite 104
Leesburg, FL 34748-7601
Phone
(352) 365-2583
Fax
(352) 728-6749
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME51560 FL Primary
Magnetic Resonance Imaging (MRI) Internal Medicine Physician 207RM1200X 51560 FL
Neuroradiology Physician 2085N0700X ME51560 FL

Addresses

Primary practice location

801 E Dixie Ave
Suite 104
Leesburg, FL 34748-7601

Mailing address

734 N 3Rd St
Suite 115
Leesburg, FL 34748-5285
Phone (352) 365-2583

Other identifiers 3

IdentifierTypeStateIssuer
048046100MedicaidFL
300097806OtherFLRR MEDICARE LMIV
300114870OtherFLRR MEDICARE RACF

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20071109000085 FL Practitioner - Diagnostic Radiology 8628974458 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.22 of 100Reported as group
Quality
95.56
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.5 of 100Reported as group
Quality
90
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51560FLMDMagnetic Resonance Imaging (MRI) Internal Medicine Physician
ME51560FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of Central Florida L L C Diagnostic Radiology CurrentSince Jan 1, 1992 Accepting new patients
Lake Medical Imaging and Breast Center at the Villages LLC Diagnostic Radiology CurrentSince Sep 25, 1998 Accepting new patients
Lake Medical Imaging and Breast Center at the Villages LLC Diagnostic Radiology PastSince Jul 25, 2021 Accepting new patients
Lake Medical Imaging and Breast Center at the Villages LLC Diagnostic Radiology PastSince Jun 27, 2021 Accepting new patients
Lake Medical Imaging and Breast Center at the Villages LLC Diagnostic Radiology PastSince Jul 25, 2021 Accepting new patients
Lake Medical Imaging and Breast Center at the Villages LLC Diagnostic Radiology PastSince Jun 27, 2021 Accepting new patients

Locations

801 E Dixie Ave
Ste 104
Leesburg, FL 34748
Phone (352) 287-5858

600 E Dixie Ave
Leesburg, FL 34748
Phone (352) 323-5090

734 N 3rd St
Ste 115
Leesburg, FL 34748
Phone (352) 365-2583

1487 S US 301
Sumterville, FL 33585
Phone (352) 568-1966

340 Heald Way
Ste 140
The Villages, FL 32163

910 Old Camp Rd
Ste 120
The Villages, FL 32162

8801 SE 165th Mulberry Ln
The Villages, FL 32162

2955 Brownwood Blvd
Ste 112
The Villages, FL 32163

1400 N US Highway 441
Ste 510
The Villages, FL 32159
Phone (352) 753-4115

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1104874288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 N 3RD ST",
            "address_2": "SUITE 115",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485285",
            "telephone_number": "352-365-2583",
            "fax_number": "352-728-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E DIXIE AVE",
            "address_2": "SUITE 104",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487601",
            "telephone_number": "352-365-2583",
            "fax_number": "352-728-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "CATHRINE",
        "middle_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME51560",
            "primary": true
        },
        {
            "code": "207RM1200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Magnetic Resonance Imaging (MRI)",
            "state": "FL",
            "license": "51560",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "FL",
            "license": "ME51560",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048046100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE LMIV",
            "identifier": "300097806",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE RACF",
            "identifier": "300114870",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.