NPIMap

Individual provider Active NPI

Jesse Wade Keller, MD

  • Medical Oncology Physician
  • Saint Louis, MO
National Provider Identifier
1174787162
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
2013011512 Issued in MO
Practice address
915 N Grand Blvd
Saint Louis, MO 63106-1621
Phone
(314) 651-4100
NPI assigned
Jul 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 2013011512 MO Primary

Addresses

Primary practice location

915 N Grand Blvd
Saint Louis, MO 63106-1621

Mailing address

7 Ladue LN
Saint Louis, MO 63124-1632
Phone (415) 706-2601

Other practice location 1

10 Barnes West Dr
Div IM Medical Oncology, MOB #2
Saint Louis, MO 63141-6287
Phone (800) 647-2098

Other identifiers 1

IdentifierTypeStateIssuer
200032614MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160614001929 MO Practitioner - Internal Medicine 4688836083 Reassigns benefits to 1 organization
I20240812001824 IL Practitioner - Internal MedicinePractitioner - Medical Oncology 4688836083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Johns Hopkins University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

10 Barnes W Dr
Saint Louis, MO 63141-6350

11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone (314) 362-7603

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013011512MOMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University Physicians in Illinois, Inc Current Accepting new patients
Washington University Physicians in Illinois, Inc. CurrentSince May 24, 2024 Accepting new patients
Washington University Physicians in Illinois, Inc CurrentSince May 24, 2024 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1418 Cross St
Ste 180
Shiloh, IL 62269
Phone (618) 607-1340

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

4921 Parkview Pl
Fl 7
Saint Louis, MO 63110
Phone (314) 362-6908

10 Barnes West Dr
#2
Saint Louis, MO 63141

Interoperability endpoints

  • Direct secure messaging: jkeller134516@direct.carenet.org

Organizations & group practices 5

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 6

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": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1174787162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 LADUE LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241632",
            "telephone_number": "415-706-2601",
            "fax_number": "415-706-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631061621",
            "telephone_number": "314-651-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Barnes West Dr",
            "address_2": "Div IM Medical Oncology, MOB #2",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631416287",
            "country_code": "US",
            "telephone_number": "800-647-2098",
            "fax_number": "314-362-3192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JESSE",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-18",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MO",
            "license": "2013011512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200032614",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "10 Barnes West Dr",
            "address_2": "Div IM Medical Oncology, MOB #2",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.