Keith L Mullenger, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

ME89087 Issued in FL

Practice address

875 Military TRL
Jupiter, FL 33458-5700

Phone

(561) 748-9828

Fax

(561) 630-4543

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

Washington University School of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Impression Imaging LLCGroup PAC ID 1759547979, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GCFDCD/Endpoint/GCFDCD

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

• Impression Imaging LLC

  • Diagnostic Radiology Physician
  • Tamarac, FL
  • NPI 1780941864
  Medicare reassignment Care Compare group NPD
• Lakes Radiology II Inc

  • Clinic/Center
  • Delray Beach, FL
  • NPI 1760528327

  Diagnostic Radiology

  NPD
• Open Magnetic Scanning of Boca Delray

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Delray Beach, FL
  • NPI 1780157453
  NPD
• Altec Diagnostics & Imaging Inc

  • Diagnostic Radiology Physician
  • Jacksonville, FL
  • NPI 1013087865
  NPD (past)
• Florida Radiology Consultants P a

  • Diagnostic Radiology Physician
  • Fort Myers, FL
  • NPI 1518911668
  NPD (past)
• Lakes Radiology II Inc

  • Diagnostic Radiology Physician
  • Delray Beach, FL
  • NPI 1780198382
  NPD (past)
• Advanced Diagnostic Imaging LTD

  • Diagnostic Radiology Physician
  • Belleville, IL
  • NPI 1235174764
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1366481079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 ANGLERS AVE",
            "address_2": "STE 24",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333126653",
            "telephone_number": "954-962-6265",
            "fax_number": "954-893-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 MILITARY TRL",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334585700",
            "telephone_number": "561-748-9828",
            "fax_number": "561-630-4543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Congress Ave Ste 230",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334453428",
            "country_code": "US",
            "telephone_number": "561-299-0003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLENGER",
        "first_name": "KEITH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME89087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summer Reedy Motes
• Jessica Mowatt, PH.D.
• Christopher Charles Muenchen, MD
• Nicole Stephanie Mule
• James P Mullen, MD
• David M Mullin, MD
• Ami Muncy, AUD
• Jacqueline Munoz, ARNP
• Monica Janet Munoz, D.O.
• Christopher Anthony Murphy, LCSW

• Diagnostic Radiology Physician in Jupiter, FL
• Providers in Jupiter, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.

Verify at the official NPI Registry.