NPIMap

Individual provider Active NPI

Thomas C Keller, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Kailua, HI
National Provider Identifier
1225297997
Registry record updated Sep 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
18249 Issued in HI
Practice address
30 Aulike St
Suite 201
Kailua, HI 96734-2739
Phone
(808) 261-4658
NPI assigned
Jun 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A128254 CA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 18249 HI Primary

Addresses

Primary practice location

30 Aulike St
Suite 201
Kailua, HI 96734-2739

Mailing address

30 Aulike St
Suite 201
Kailua, HI 96734-2739
Phone (808) 261-4658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, TX2 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
I20150922001463 HI Practitioner - Orthopedic Surgery 9537384011 Reassigns benefits to 1 organization
I20190501001729 TX Practitioner - Orthopedic Surgery 9537384011 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Virginia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanana Chiefs ConferenceGroup PAC ID 9537050109, 148 clinicians

Practice addresses (Care Compare)

1717 W Cowles St
Fairbanks, AK 99701-5926
Phone (907) 451-6682

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.93 of 100Reported as group
Quality
70.1
Promoting interoperability
100
Improvement activities
40
Cost
83.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)21
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A128254CAMDOrthopaedic Surgery Physician
18249HIMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hilo Benioff Medical Center CurrentSince Aug 3, 2022 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Apr 9, 2019 Accepting new patients
Tanana Chiefs Conference CurrentSince Nov 5, 2019 Accepting new patients
Hilo Benioff Medical Center CurrentSince Aug 3, 2022 Accepting new patients
Tanana Chiefs Conference CurrentSince Nov 5, 2019 Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

1717 W Cowles St
Fairbanks, AK 99701
Phone (907) 452-6682

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

Interoperability endpoints

  • Direct secure messaging: thomas.keller.1@15989.direct.athenahealth.com
  • Direct secure messaging: tckeller@direct.anthc.org
  • Direct secure messaging: tkeller196286@direct.cshs.org
  • Direct secure messaging: thomaskellermd@windward.ssdirect.aprima.com

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443398400000",
    "number": "1225297997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 AULIKE ST",
            "address_2": "SUITE 201",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342739",
            "telephone_number": "808-261-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 AULIKE ST",
            "address_2": "SUITE 201",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342739",
            "telephone_number": "808-261-4658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "THOMAS",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2015-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A128254",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "HI",
            "license": "18249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

Verify at the official NPI Registry.