NPIMap

Individual provider Active NPI

Gregory C Keller, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Jacksonville, FL
National Provider Identifier
1285638965
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
ME62258 Issued in FL
Practice address
1325 San Marco Blvd Ste 200
Credentialing Department
Jacksonville, FL 32207-8566
Phone
(904) 346-3465
Fax
(904) 399-1537
NPI assigned
Jun 9, 2005
Last updated
Mar 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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 ME62258 FL
Orthopaedic Surgery of the Spine Physician 207XS0117X ME62258 FL Primary

Addresses

Primary practice location

1325 San Marco Blvd Ste 200
Credentialing Department
Jacksonville, FL 32207-8566

Mailing address

1325 San Marco Blvd Ste 200
Jacksonville, FL 32207-8566
Phone (904) 346-3465

Other identifiers 2

IdentifierTypeStateIssuer
00655069AMedicaidGA
376096100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Joireferrals@joi.medalliesdirect.net Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060714000238 FL Practitioner - Orthopedic SurgeryPractitioner - Other (Physician) 5799798781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Vanderbilt University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jacksonville Orthopaedic Institute IncGroup PAC ID 5193625499, 60 clinicians

Practice addresses (Care Compare)

1325 San Marco Blvd
Suite 200
Jacksonville, FL 32207-8566
Phone (904) 346-3465

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.01 of 100Reported as group
Improvement activities
40
Cost
74.03

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Spinal fusion222
Laminectomy or laminotomy (partial removal of spine bones)54
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME62258FLMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jacksonville Orthopaedic Institute Inc Orthopaedic Surgery CurrentSince Jun 9, 2010 Accepting new patients

Locations

1325 San Marco Blvd
Ste 200
Jacksonville, FL 32207
Phone (904) 346-3465

2 Shircliff Way
Ste 300
Jacksonville, FL 32204
Phone (904) 308-7959

7740 Point Meadows Dr
Ste 7
Jacksonville, FL 32256
Phone (904) 202-6400

1577 Roberts Dr
Ste 225226
Jacksonville Beach, FL 32250
Phone (904) 241-1204

Interoperability endpoints

  • Direct secure messaging: gregorykeller@joi.medalliesdirect.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1285638965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078566",
            "telephone_number": "904-346-3465",
            "fax_number": "904-399-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD STE 200",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078566",
            "telephone_number": "904-346-3465",
            "fax_number": "904-399-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "GREGORY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME62258",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "FL",
            "license": "ME62258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00655069A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376096100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Joireferrals@joi.medalliesdirect.net",
            "affiliation": "N",
            "endpointDescription": "Jacksonville Orthopaedic Institute",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HTML",
            "address_1": "1325 San Marco Blvd Ste 200",
            "address_2": "Credentialing Department",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322078566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.