NPIMap

Individual provider Active NPI

Kenneth Keller, M.D.

  • Orthopaedic Surgery Physician
  • Fort Morgan, CO
National Provider Identifier
1104976802
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
36926 Issued in CO
Practice address
220 E Beaver Ave
Fort Morgan, CO 80701-3103
Phone
(970) 542-1707
Fax
(970) 542-1708
NPI assigned
Jan 12, 2007
Last updated
Jul 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 36926 CO Primary

Addresses

Primary practice location

220 E Beaver Ave
Fort Morgan, CO 80701-3103

Mailing address

220 E Beaver Ave
Fort Morgan, CO 80701-3103
Phone (970) 542-1707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20120723000754 CO Practitioner - Orthopedic Surgery 1658354543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
JS Weill Medical College, Cornell University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

1000 Lincoln St
Fort Morgan, CO 80701-3290

1000 Lincoln St 207 Neuro
Centura Neurology Ft Morgan
Fort Morgan, CO 80701-3290
Phone (970) 867-6430

41 State Hwy 67
Woodland Park, CO 80863-5008
Phone (719) 776-4780

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
68.01 of 100Reported as group
Quality
76.44
Promoting interoperability
100
Improvement activities
40
Cost
10

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement13
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36926COMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Jul 1, 2022 Accepting new patients
Colorado Plains Physician Practices LLC CurrentSince Jun 1, 2012 Accepting new patients
Catholic Health Initiatives Colorado Orthopaedic Surgery CurrentSince Jul 1, 2022 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Catholic Health Initiatives Colorado Orthopaedic Surgery Past Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

1000 Lincoln St
Ste 100
Fort Morgan, CO 80701
Phone (970) 542-1707

220 E Beaver Ave
Fort Morgan, CO 80701
Phone (970) 458-5216

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 8

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 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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1104976802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 E BEAVER AVE",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807013103",
            "telephone_number": "970-542-1707",
            "fax_number": "970-542-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E BEAVER AVE",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807013103",
            "telephone_number": "970-542-1707",
            "fax_number": "970-542-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CO",
            "license": "36926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Morgan, CO

Sources for this page

Verify at the official NPI Registry.