David Scott Ketner Jr., M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

254818 Issued in NY

Practice address

1276 Fulton Ave RM 208
Bronx, NY 10456-3402

Phone

(171) 890-1891

Fax

(718) 901-8918

NPI assigned

May 3, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

SBH Physicians PCGroup PAC ID 3072798941, 178 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bronxcare Hospital Center Hospital, Bronx, NY, CCN 330009
• St Barnabas Hospital Hospital, Bronx, NY, CCN 330399

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: dketner18907@sbhny.direct-ci.net

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.

• Bronxcare Health System

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1245390855
  Medicare reassignment Care Compare group NPD
• SBH Physicians, PC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1740595917
  Medicare reassignment Care Compare group NPD
• Bronxcare Health System

  • Ophthalmology Physician
  • Bronx, NY
  • NPI 1548310758
  NPD
• Bronxcare Health System

  • Methadone Clinic
  • Bronx, NY
  • NPI 1801428222
  NPD
• SBH Physicians, PC

  • Pediatrics Physician
  • Bronx, NY
  • NPI 1457665937
  NPD
• Bronxcare Health System

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1417027558
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bronxcare Health System

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1417027558
  Care Compare affiliation
• St. Barnabas Hospital

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1548367873
  Care Compare affiliation

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

{
    "created_epoch": "1209772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1407022015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE STE 3D",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE RM 208",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "171-890-1891",
            "fax_number": "718-901-8918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Temple St",
            "address_2": "Suite 3D",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065102715",
            "country_code": "US",
            "telephone_number": "203-785-2020",
            "fax_number": "203-785-7090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETNER",
        "first_name": "DAVID",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-03",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "254818",
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NY",
            "license": "254818",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKenzie Kessler, MHC
• Richard Lee Kessner, PH.D.
• Emily Kestenbaum
• Meir Kestenbaum
• Delally Ketemepi, RN
• Khadejha Ketter
• Nicole Chantell Ketter, LMSW
• Sarah Kevelson, M.D.
• Kevin L Cintron Rd LLC
• Kevin Obi NP in Psychiatry PLLC

• Ophthalmology Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.