Individual provider Active NPI

Danielle Keller

  • Family Nurse Practitioner
  • Munster, IN
National Provider Identifier
1457922205
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209023962 Issued in IL
Practice address
8135 Calumet Ave
Munster, IN 46321-1701
Phone
(219) 513-2000
Fax
(219) 513-2001
NPI assigned
Jul 2, 2021
Last updated
Aug 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71011448A IN
Family Nurse Practitioner 363LF0000X 209023962 IL Primary

Addresses

Primary practice location

8135 Calumet Ave
Munster, IN 46321-1701

Mailing address

8135 Calumet Ave
Munster, IN 46321-1701
Phone (219) 513-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20211102001215 IL Practitioner - Nurse Practitioner 1658776968 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Medical Staffing LLCGroup PAC ID 1759712698, 35 clinicians
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians

Practice addresses (Care Compare)

200 E Fairman Ave
Watseka, IL 60970-1644
Phone (815) 432-5841

500 W Court St
Kankakee, IL 60901-3661
Phone (815) 937-2100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.41 of 100Reported as group
Quality
86.81
Improvement activities
40
Cost
77.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71011448AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 2, Inc CurrentSince Oct 15, 2021 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Oct 15, 2021 Accepting new patients
Trinity Medical Staffing LLC CurrentSince Sep 1, 2024 Accepting new patients
Cepamerica Illinois LLP CurrentSince Aug 16, 2022 Accepting new patients
Cepamerica Illinois LLP CurrentSince Aug 16, 2022 Accepting new patients
Cepamerica Illinois LLP Current Accepting new patients
The Methodist Hospitals, Inc PastSince Jul 4, 2021 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

600 S Randall Rd
Algonquin, IL 60102
Phone (224) 783-4300

2250 N Illinois Ave
Carbondale, IL 62901
Phone (618) 833-1691

219 W Chicago Ave
Chicago, IL 60654
Phone (312) 878-1945

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946
Phone (618) 252-4956

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

200 E Fairman Ave
Watseka, IL 60970
Phone (815) 432-5201

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Interoperability endpoints

  • Direct secure messaging: danielle.keller.1@15486.direct.athenahealth.com
  • Direct secure messaging: dkeller244518@uchospital.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1457922205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8135 CALUMET AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211701",
            "telephone_number": "219-513-2000",
            "fax_number": "219-513-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8135 CALUMET AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211701",
            "telephone_number": "219-513-2000",
            "fax_number": "219-513-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-02",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011448A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209023962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.