NPIMap

Individual provider Active NPI

Jennifer Keller, M.D.

  • Surgical Oncology Physician
  • Saint Louis, MO
National Provider Identifier
1437530953
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
2022027081 Issued in MO
Practice address
3635 Vista Ave
Saint Louis, MO 63110-2539
Phone
(314) 577-8317
NPI assigned
Jun 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 2015017624 MO
Surgical Oncology Physician 2086X0206X 2022027081 MO Primary

Addresses

Primary practice location

3635 Vista Ave
Saint Louis, MO 63110-2539

Mailing address

7470A Delmar Blvd
Saint Louis, MO 63130-4034
Phone (847) 275-3322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220818001376 MO Practitioner - Surgical Oncology 5294037610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Saint Louis University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

400 Medical PLZ
Suite 100
Lake St Louis, MO 63367-1493
Phone (636) 639-8600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2015017624MOMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Medical Group Inc. CurrentSince Jun 12, 2024 Accepting new patients
SSM Medical Group, Inc. CurrentSince Jun 12, 2024 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
Ozarks Medical Center Past Accepting new patients
SSM-Sluh Inc Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Locations

400 Medical Plz
Ste 100
Lake St Louis, MO 63367
Phone (636) 639-8600

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1433894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1437530953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7470A DELMAR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631304034",
            "telephone_number": "847-275-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 VISTA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102539",
            "telephone_number": "314-577-8317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-10",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2015017624",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "MO",
            "license": "2022027081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.