NPIMap

Individual provider Active NPI

Brett Keller, DO

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Phillipsburg, NJ
National Provider Identifier
1306104419
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
25MB09806800 Issued in NJ
Practice address
755 Memorial Pkwy
BLDG 200, Suite 201
Phillipsburg, NJ 08865-2748
Phone
(908) 859-8884
Fax
(908) 859-8841
NPI assigned
Apr 26, 2012
Last updated
Aug 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 25MB09806800 NJ Primary

Addresses

Primary practice location

755 Memorial Pkwy
BLDG 200, Suite 201
Phillipsburg, NJ 08865-2748

Mailing address

801 Ostrum St
Bethlehem, PA 18015-1000
Phone (484) 526-8046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160926001936 NJ Practitioner - Family PracticePractitioner - Sports Medicine 3274820881 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Philadelphia College of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Warren Physician Group PCGroup PAC ID 9739093675, shared by 3 NPIs, 374 clinicians

Practice addresses (Care Compare)

755 Memorial Pkwy
Phillipsburg, NJ 08865-2748

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB09806800NJMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Warren Physician Group, PC CurrentSince Aug 12, 2016 Accepting new patients
St. Luke's Warren Physician Group, PC Current Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Aug 12, 2016 Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Oct 1, 2021 Accepting new patients
St. Luke's Warren Physician Group, PC Current Accepting new patients
Star Community Health, Inc CurrentSince Jul 1, 2023 Accepting new patients
Star Community Health, Inc CurrentSince Jul 1, 2023 Accepting new patients
St. Luke's Physician Group, Inc. Past Accepting new patients

Locations

185 Roseberry St
Bldg 2ND
Phillipsburg, NJ 08865
Phone (908) 847-2619

409 Coventry Dr
Phillipsburg, NJ 08865
Phone (908) 213-0029

755 Memorial Pkwy
Ste 201
Phillipsburg, NJ 08865
Phone (484) 503-0055

755 Memorial Pkwy
Ste 300
Phillipsburg, NJ 08865
Phone (908) 454-6303

755 Memorial Pkwy
Ste 302
Phillipsburg, NJ 08865
Phone (908) 847-6722

279 State Route 31 S
Washington, NJ 07882
Phone (908) 689-2201

315 State Route 31 S
Washington, NJ 07882
Phone (908) 689-0777

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Organizations & group practices 8

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": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1306104419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-8046",
            "fax_number": "484-526-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 MEMORIAL PKWY",
            "address_2": "BLDG 200, SUITE 201",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652748",
            "telephone_number": "908-859-8884",
            "fax_number": "908-859-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "BRETT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-26",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NJ",
            "license": "25MB09806800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

Verify at the official NPI Registry.