Derek H. Keller, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD13888 Issued in RI

Practice address

593 Eddy Street
Davol 129
Providence, RI 02903-4923

Phone

(401) 444-4933

Fax

(401) 444-5090

NPI assigned

Sep 18, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Boston University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Narragansett Bay Anesthesia LLCGroup PAC ID 5991774929, 95 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South County Hospital Inc Hospital, Wakefield, RI, CCN 410008
• Our Lady of Fatima Hospital Hospital, North Providence, RI, CCN 410005

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Narragansett Bay Anesthesia, LLC

  • Anesthesiology Physician
  • Warwick, RI
  • NPI 1861445728
  Medicare reassignment Care Compare group NPD
• Lifespan Physician Group, Inc.

  • Psychiatry Physician
  • Providence, RI
  • NPI 1548506793
  NPD (past)

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

• Prospect Chartercare Sjhsri, LLC

  • General Acute Care Hospital
  • North Providence, RI
  • NPI 1871918870
  Care Compare affiliation
• South County Hospital Healthcare System

  • General Acute Care Hospital
  • Wakefield, RI
  • NPI 1952366106
  Care Compare affiliation

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1649420274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE VIRGINIA AVENUE",
            "address_2": "SUITE 201",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02905",
            "telephone_number": "401-490-0916",
            "fax_number": "401-490-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY STREET",
            "address_2": "DAVOL 129",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4933",
            "fax_number": "401-444-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "DEREK",
        "middle_name": "H.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-18",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "236696",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "RI",
            "license": "13888",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "RI",
            "license": "MD13888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabor Istvan Keitner, MD
• Lana Keker, CRNA
• Annette L Kelleher, NP
• Leah Kelleher
• Linda Michelle Kelleher, RD,LDN,LPN,CDE
• Christine Marie Kelley-Tavares, CPS
• Emma Kelley, MS, CGC
• Hayleigh Kelley
• Kaitlin Kelley, PMHNP
• Kerri Kelley, LICSW

• Anesthesiology Physician in Providence, RI
• Providers in Providence, RI by specialty
• Anesthesiology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; 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.