NPIMap

Individual provider Active NPI

Paul S Keller, O.D.

  • Optometrist
  • Rochester Hills, MI
National Provider Identifier
1396990941
Registry record updated Mar 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002455 Issued in MI
Practice address
2861 S Rochester Rd
Hampton Village
Rochester Hills, MI 48307-4579
Phone
(248) 852-5230
NPI assigned
Nov 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002455 MI Primary

Addresses

Primary practice location

2861 S Rochester Rd
Hampton Village
Rochester Hills, MI 48307-4579

Mailing address

2861 S Rochester Rd
Hampton Village
Rochester Hills, MI 48307-4579
Phone (248) 852-5230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pearle Vision Inc Optometrist Past Accepting new patients
Pearle Vision Inc Past Accepting new patients
Luxottica of America Inc Past Accepting new patients
Luxottica Retail North America Inc Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269820800000",
    "number": "1396990941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2861 S ROCHESTER RD",
            "address_2": "HAMPTON VILLAGE",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483074579",
            "telephone_number": "248-852-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2861 S ROCHESTER RD",
            "address_2": "HAMPTON VILLAGE",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483074579",
            "telephone_number": "248-852-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "PAUL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-24",
        "last_updated": "2010-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.