Michael E. Keesler, J.D., PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PS018050 Issued in PA

Practice address

77 Rochelle Ave
Philadelphia, PA 19128-3809

Phone

(215) 704-9832

NPI assigned

Jul 9, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Juris Doctor, Doctor of Philosophy

Practice roles

Locations

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.

• Fox and Ferns Mental Health, LLC

  • Adult Mental Health Clinic/Center
  • Philadelphia, PA
  • NPI 1184269664
  Medicare reassignment NPD Authorized official
• Diversified Psychological Resources, P.C.

  • Clinical Neuropsychologist
  • Philadelphia, PA
  • NPI 1588711006
  Medicare reassignment NPD
• Jefferson University Physicians

  • Neurology Physician
  • Philadelphia, PA
  • NPI 1295909422
  NPD (past)
• Optimal Mental Health & Wellness, PLLC

  • Adult Mental Health Clinic/Center
  • Jenkintown, PA
  • NPI 1003776295
  NPD (past)

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

{
    "created_epoch": "1468022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1609228022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 ROCHELLE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191283809",
            "telephone_number": "215-704-9832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 ROCHELLE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191283809",
            "telephone_number": "215-704-9832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEESLER",
        "first_name": "MICHAEL",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "J.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-09",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS018050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quinn Keenan
• Jessica Lynn Keeney, PA-C
• Keeping Loves at Home Homecare LLC
• Parin Keerthi
• Markietra Keese
• Sydney Keesler, LCSW
• Tierney A Keeton-Tucker, DNP, APN, AGPCNP-BC
• Rose Mary Keevill, PHARM.D.
• Andrew Keeys, BS
• Jodi Michele Kefer, MD

• Clinical Neuropsychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Neuropsychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; 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.