Individual provider Active NPI

Marina Keller, MD

  • Infectious Disease Physician
  • Valhalla, NY
National Provider Identifier
1194075549
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
240571-1 Issued in NY
Practice address
100 Woods Rd
Valhalla, NY 10595-1530
Phone
(914) 493-6616
Fax
(914) 493-5827
NPI assigned
Sep 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 240571-1 NY
Infectious Disease Physician 207RI0200X 240571-1 NY Primary

Addresses

Primary practice location

100 Woods Rd
Valhalla, NY 10595-1530

Mailing address

19 Bradhurst Ave Ste 3100N
Hawthorne, NY 10532-2140
Phone (914) 909-9018

Other practice location 1

19 Bradhurst Ave Ste 3060N
Hawthorne, NY 10532-2180
Phone (914) 372-7887

Other identifiers 1

IdentifierTypeStateIssuer
03533795MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Marina.Keller@wmchealth.cernerdirect.com Direct

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
I20130223000114 NY Practitioner - Internal MedicinePractitioner - Infectious Disease 8820243843 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
McGill University, Faculty of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Westchester Medical Center Advanced Physician Services PCGroup PAC ID 3173660776, 879 clinicians

Practice addresses (Care Compare)

100 Woods Rd
Valhalla, NY 10595-1530

19 Bradhurst Ave
Hawthorne, NY 10532-2140

95 Grasslands Rd
Valhalla, NY 10595-1652
Phone (914) 493-6940

Hospital & facility affiliations

  • Westchester Medical Center Hospital, Valhalla, NY, CCN 330234

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
240571-1NYMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middletown Medical PC CurrentSince Dec 1, 2019 Accepting new patients
Middletown Medical PC Internal Medicine CurrentSince Dec 1, 2019 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Feb 15, 2021 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Feb 15, 2021 Accepting new patients

Locations

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

19 Bradhurst Ave
Ste 3060N
Hawthorne, NY 10532
Phone (914) 372-7887

111 Maltese Dr
Middletown, NY 10940

60 Prospect Ave
Middletown, NY 10940
Phone (845) 342-2424

707 E Main St
Middletown, NY 10940
Phone (845) 333-1000

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: kellerm1@hiemail.healtheconnections.org
  • Direct secure messaging: marina.keller@wmchealth.cernerdirect.com

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.

Hospital & facility affiliations 1

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": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1194075549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE STE 3100N",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-909-9018",
            "fax_number": "914-909-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOODS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530",
            "telephone_number": "914-493-6616",
            "fax_number": "914-493-5827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Bradhurst Ave Ste 3060N",
            "address_purpose": "LOCATION",
            "city": "Hawthorne",
            "state": "NY",
            "postal_code": "105322180",
            "country_code": "US",
            "telephone_number": "914-372-7887",
            "fax_number": "914-372-7884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLER",
        "first_name": "MARINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "240571-1",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "240571-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03533795",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Marina.Keller@wmchealth.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "19 Bradhurst Ave Ste 3060N",
            "city": "Hawthorne",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105322180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.