NPIMap

Individual provider Active NPI

Eric James Keller, MD, MA

  • Diagnostic Radiology Physician
  • Wilmington, NC
National Provider Identifier
1588056113
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2023-02365 Issued in NC
Practice address
1025 Medical Center Dr
Wilmington, NC 28401-7354
Phone
(910) 762-3882
NPI assigned
Feb 18, 2015
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2023-02365 NC Primary
Vascular & Interventional Radiology Physician 2085R0204X A163722 CA

Addresses

Primary practice location

1025 Medical Center Dr
Wilmington, NC 28401-7354

Mailing address

1025 Medical Center Dr
Wilmington, NC 28401-7354
Phone (910) 762-3882

Other practice location 1

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-6855

Other practice location 2

30 E Huron St
Apt 2004
Chicago, IL 60611-2766
Phone (260) 409-7602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240823002789 NC Practitioner - Diagnostic Radiology 9739561416 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Northwestern University Feinberg Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delaney Radiologists Group PLLCGroup PAC ID 4981684875, 55 clinicians
Delaney Radiologists PAGroup PAC ID 6305813684, 55 clinicians

Practice addresses (Care Compare)

1025 Medical Ctr Dr
Wilmington, NC 28401-7354
Phone (910) 762-3882

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.57 of 100Reported as group
Quality
80.67
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
81.72 of 100Reported as group
Quality
88.57
Improvement activities
40
Cost
60.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023-02365NCMDDiagnostic Radiology Physician
A163722CAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington ASC LLC CurrentSince Aug 1, 2024 Accepting new patients
Wilmington Health PLLC CurrentSince Aug 1, 2024 Accepting new patients
Delaney Radiologists PA CurrentSince Aug 1, 2024 Accepting new patients
Delaney Radiologists Group PLLC CurrentSince Aug 1, 2024 Accepting new patients
Port City Operating Company, LLC Past Accepting new patients

Locations

1025 Medical Center Dr
Wilmington, NC 28401
Phone (910) 762-3882

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

2800 Ashton Dr
Ste 102
Wilmington, NC 28412
Phone (910) 762-3882

Interoperability endpoints

  • Direct secure messaging: ekeller1484387@direct.novanthealth.org

Organizations & group practices 5

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 10

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": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1588056113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017354",
            "telephone_number": "910-762-3882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017354",
            "telephone_number": "910-762-3882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Pasteur Dr",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "CA",
            "postal_code": "943052200",
            "country_code": "US",
            "telephone_number": "650-723-6855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 E Huron St",
            "address_2": "Apt 2004",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112766",
            "country_code": "US",
            "telephone_number": "260-409-7602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLER",
        "first_name": "ERIC",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD, MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-18",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2023-02365",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A163722",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.