Individual provider Active NPI

Hana Keller, PA-C

  • Physician Assistant
  • Lagrange, IN
National Provider Identifier
1306514682
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003465A Issued in IN
Practice address
2500 N Detroit St
Lagrange, IN 46761-1158
Phone
(260) 463-2133
Fax
(260) 463-3775
NPI assigned
Sep 1, 2021
Last updated
Aug 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1183582 IN
Physician Assistant 363A00000X 10003465A IN Primary

Addresses

Primary practice location

2500 N Detroit St
Lagrange, IN 46761-1158

Mailing address

PO Box 236
Lagrange, IN 46761-0236
Phone (260) 463-2133

Other practice location 1

702 Van Buren St
Fort Wayne, IN 46802-3697
Phone (260) 425-3000

Other practice location 2

2520 E DuPont Rd
Fort Wayne, IN 46825-1675
Phone (260) 416-3000

Other practice location 3

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4160
Phone (260) 435-7001

Other practice location 4

1113 W 7th St
Auburn, IN 46706-2016
Phone (260) 909-5163

Other practice location 5

6515 Stellhorn Rd
Fort Wayne, IN 46815-5436
Phone (260) 458-3212

Other practice location 6

3929 E State Blvd
Fort Wayne, IN 46805-4948
Phone (260) 479-3001

Other identifiers 1

IdentifierTypeStateIssuer
0065842MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211201001097 IN Practitioner - Physician Assistant 6608266952 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Urgent Care Professionals PLLCGroup PAC ID 9830437946, 36 clinicians

Practice addresses (Care Compare)

1113 W 7TH St
Auburn, IN 46706-2016
Phone (708) 922-0911

2680 Escalade Way
Warsaw, IN 46582-5671
Phone (708) 922-0911

3019 N National Rd
Columbus, IN 47203
Phone (708) 922-0911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1183582INMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Internal Medicine Associates, PC PastSince Aug 6, 2019 Accepting new patients
Northeast Internal Medicine Associates, PC Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1306514682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 236",
            "city": "LAGRANGE",
            "state": "IN",
            "postal_code": "467610236",
            "telephone_number": "260-463-2133",
            "fax_number": "260-463-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N DETROIT ST",
            "city": "LAGRANGE",
            "state": "IN",
            "postal_code": "467611158",
            "telephone_number": "260-463-2133",
            "fax_number": "260-463-3775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "702 Van Buren St",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468023697",
            "country_code": "US",
            "telephone_number": "260-425-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2520 E DuPont Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468251675",
            "country_code": "US",
            "telephone_number": "260-416-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7950 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468044160",
            "country_code": "US",
            "telephone_number": "260-435-7001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1113 W 7th St",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "IN",
            "postal_code": "467062016",
            "country_code": "US",
            "telephone_number": "260-909-5163",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6515 Stellhorn Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468155436",
            "country_code": "US",
            "telephone_number": "260-458-3212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3929 E State Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468054948",
            "country_code": "US",
            "telephone_number": "260-479-3001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLER",
        "first_name": "HANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "1183582",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003465A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0065842",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, IN

Sources for this page

Verify at the official NPI Registry.