Brian Kellert, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

20A15787 Issued in CA

Practice address

110 Tampico Drive Suite 100
Walnut Creek, CA 94598-1267

Phone

(925) 891-9033

Fax

(925) 891-9066

NPI assigned

Jul 6, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Obstetrics/Gynecology

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Group practices

Diablo Valley Perinatal Associates, IncGroup PAC ID 3274716345, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Diablo Valley Perinatal Associates, Inc

  • Maternal & Fetal Medicine Physician
  • Walnut Creek, CA
  • NPI 1255645172
  Medicare reassignment Care Compare group NPD
• John Muir Health

  • Rehabilitation Hospital Unit
  • Walnut Creek, CA
  • NPI 1447269303
  NPD (past)
• Stanford Health Care Tri-Valley

  • General Acute Care Hospital
  • Pleasanton, CA
  • NPI 1144389941
  NPD (past)

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1215224761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 TAMPICO DRIVE SUITE 100",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982961",
            "telephone_number": "925-891-9033",
            "fax_number": "925-891-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 TAMPICO DRIVE SUITE 100",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945981267",
            "telephone_number": "925-891-9033",
            "fax_number": "925-891-9066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "395 W 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101267",
            "country_code": "US",
            "telephone_number": "614-293-8515",
            "fax_number": "614-293-5877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLERT",
        "first_name": "BRIAN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A15787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "20A15787",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rita Keileh, PHYSICIAN ASSISTANT
• Scott Edward Keith, DDS, MS
• Varujan Arek Keledjian, M.D.
• Colleen Keller, PT
• Walter G. Keller, MD
• Kailen Kelley
• Mia Marie Kellner
• Alexis Kellog
• Devlin Kelly, PH.D.
• Marisa Anne Kelly

• Obstetrics & Gynecology Physician in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.