Individual provider Active NPI

Debra Roy Keller, PA

  • Medical Physician Assistant
  • Rochester, NY
National Provider Identifier
1316944812
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
007617 Issued in NY
Practice address
2655 Ridgeway Ave
Suite 180
Rochester, NY 14626-4296
Phone
(585) 368-4000
Fax
(585) 225-2685
NPI assigned
Jun 30, 2005
Last updated
Jan 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 007617 NY Primary

Addresses

Primary practice location

2655 Ridgeway Ave
Suite 180
Rochester, NY 14626-4296

Mailing address

2655 Ridgeway Ave
Suite 180
Rochester, NY 14626-4296
Phone (585) 368-4000

Other names 1

  • Debra Roy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040108000440 NY Practitioner - Physician Assistant 8527967520 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

100 Kings Hwy S
Rochester, NY 14617-5504

1415 Portland Ave
Rochester, NY 14621-3022

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-3122

1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004473GAMDOccupational Therapist
007617NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C CurrentSince Oct 1, 2022 Accepting new patients
Rochester General Hospital CurrentSince Oct 1, 2022 Accepting new patients
The Unity Hospital of Rochester CurrentSince Apr 12, 2006 Accepting new patients
The Unity Hospital of Rochester CurrentSince Apr 12, 2006 Accepting new patients
Rochester General Hospital CurrentSince Oct 1, 2022 Accepting new patients
Rochester General Hospital Past Accepting new patients
Surgical Assistants of America, Inc. Past Accepting new patients

Locations

2200 Penfield Rd
Penfield, NY 14526
Phone (585) 377-6170

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

2655 Ridgeway Ave
Ste 180
Rochester, NY 14626
Phone (585) 368-4000

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.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1316944812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 RIDGEWAY AVE",
            "address_2": "SUITE 180",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264296",
            "telephone_number": "585-368-4000",
            "fax_number": "585-225-2685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 RIDGEWAY AVE",
            "address_2": "SUITE 180",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264296",
            "telephone_number": "585-368-4000",
            "fax_number": "585-225-2685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "DEBRA",
        "middle_name": "ROY",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "007617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "ROY",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.