Elizabeth Greer Keller

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA56999 Issued in CA

Practice address

2021 Santa Monica Blvd Ste 440E
Santa Monica, CA 90404-2154

Phone

(310) 453-1386

Fax

(310) 453-4786

NPI assigned

Sep 10, 2019

Sex

Female

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 CA

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family and Wound Care SolutionsGroup PAC ID 8123541463, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Family and Wound Care Solutions

  • Family Nurse Practitioner
  • Tarzana, CA
  • NPI 1689482416
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1629627864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9344 NATIONAL BLVD APT 8",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900342925",
            "telephone_number": "717-679-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD STE 440E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042154",
            "telephone_number": "310-453-1386",
            "fax_number": "310-453-4786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "ELIZABETH",
        "middle_name": "GREER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA56999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Kearney, OMD LAC
• Positron Kebebew, M.D.
• Amy Sargious Kehl, MD
• Devin Kehl, M.D.
• Farhad Keliddari, M.D.
• Lisa Anne Kelley
• Kelly Bickle MD Inc
• Colleen Mary Saoirse Kelly, MFT
• Daniel F Kelly, MD
• Josie Kelly, MFT

• Physician Assistant in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.