Active NPI
Hana Keller, PA-C
- Physician Assistant
- Lagrange, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10003465A
- 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, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0065842 | Medicaid | OH |
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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1183582 | IN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Internal Medicine Associates, PC | Past | 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.
-
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IN
-
- Emergency Medicine Physician
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- NPI 1013951219
-
- Physician Assistant
- Fort Wayne, IN
- NPI 1528090610
-
- Internal Medicine Physician
- Lagrange, IN
- NPI 1174518500
-
- Primary Care Nurse Practitioner
- Lagrange, IN
- NPI 1366859779
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.