Individual provider Active NPI

Christopher J Keto, M.D.

  • Urology Physician
  • Fort Wayne, IN
National Provider Identifier
1134446339
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
01095110A Issued in IN
Practice address
7910 W Jefferson Blvd Ste 205B
Fort Wayne, IN 46804-0072
Phone
(260) 458-3460
Fax
(260) 458-3461
NPI assigned
Apr 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 67023 WI
Urology Physician 208800000X 01095110A IN Primary

Addresses

Primary practice location

7910 W Jefferson Blvd Ste 205B
Fort Wayne, IN 46804-0072

Mailing address

6920 Pointe Inverness Way Ste 200
Fort Wayne, IN 46804-7934
Phone (260) 458-3460

Other practice location 1

2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (920) 288-8280

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address christopher.keto@lutheranhealthnetwork.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170731001875 WI Practitioner - Urology 4981844743 Reassigns benefits to 11 organizations
I20241112003068 IN Practitioner - Urology 4981844743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

7910 W Jefferson Blvd
Suite 205B
Fort Wayne, IN 46804-4159
Phone (260) 432-2297

Hospital & facility affiliations

  • Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017
  • Kosciusko Community Hospital Hospital, Warsaw, IN, CCN 150133
  • Marion General Hospital Hospital, Marion, IN, CCN 150011
  • Bluffton Regional Medical Center Hospital, Bluffton, IN, CCN 150075

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67023WIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Medical Group LLC CurrentSince Nov 5, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Oct 16, 2023 Accepting new patients
Flambeau Hospital Inc CurrentSince Oct 16, 2023 Accepting new patients
Froedtert Manitowoc Medical Group, LLC CurrentSince Mar 24, 2023 Accepting new patients
Memorial Hospital Inc CurrentSince Oct 16, 2023 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Oct 16, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Oct 16, 2023 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Oct 16, 2023 Accepting new patients
Baycare Clinic LLP CurrentSince Aug 1, 2017 Accepting new patients
Lutheran Medical Group LLC CurrentSince Nov 5, 2024 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Flambeau Hospital Inc CurrentSince Oct 16, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Oct 16, 2023 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Oct 16, 2023 Accepting new patients
Marshfield Clinic Inc CurrentSince Oct 16, 2023 Accepting new patients
Baycare Clinic LLP CurrentSince Aug 1, 2017 Accepting new patients
Memorial Hospital Inc CurrentSince Oct 16, 2023 Accepting new patients

Locations

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

7910 W Jefferson Blvd
Ste 205B
Fort Wayne, IN 46804
Phone (260) 458-3460

7916 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-2298

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

1035 Kepler Dr
Green Bay, WI 54311

2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400

164 N Broadway
Green Bay, WI 54303
Phone (920) 965-4055

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

1414 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 320-2011

323 S 18th Ave
Sturgeon Bay, WI 54235
Phone (920) 743-5566

Interoperability endpoints

  • Direct secure messaging: christopher.keto@lutheranhealthnetwork.cernerdirect.com
  • Direct secure messaging: cketo612382@direct.froedtert.com

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 7

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": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1134446339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-458-3460",
            "fax_number": "260-458-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 W JEFFERSON BLVD STE 205B",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468040072",
            "telephone_number": "260-458-3460",
            "fax_number": "260-458-3461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2845 Greenbrier Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543116519",
            "country_code": "US",
            "telephone_number": "920-288-8280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETO",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-27",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WI",
            "license": "67023",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "01095110A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christopher.keto@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "DM",
            "address_1": "7910 W Jefferson Blvd Ste 205B",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468040072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.