Bart R Keller, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0003377 Issued in CO

Practice address

410 S Wilcox St
Castle Rock, CO 80104-2662

Phone

(303) 688-6900

Fax

(303) 660-6504

NPI assigned

Jul 14, 2005

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16409/brand/1/csg/1/fhir/r4

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.

• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD
• Colorado Orthopaedics PC

  • Orthopaedic Surgery Physician
  • Colorado Springs, CO
  • NPI 1255728861
  NPD (past)
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • General Practice Physician
  • Aurora, CO
  • NPI 1811502990
  NPD (past)

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1679571475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 S WILCOX ST",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801042662",
            "telephone_number": "303-688-6900",
            "fax_number": "303-660-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S WILCOX ST",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801042662",
            "telephone_number": "303-688-6900",
            "fax_number": "303-660-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "BART",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0003377",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601002360",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylin Louise Keenan, OTR/L
• Kimberly Jo Keene, D.C.
• Stephanie Renee Keene, PA-C
• Tara K Keesey, OD
• Quinn Reiley Keleher, RD
• Courtney L Kelley, MOTR
• Adele Kelso, LCSW
• Alexis Amber Kemp, NP
• Rowan M Kenee, OD
• Dawna T Kerby, LPC

• Physician Assistant in Castle Rock, CO
• Providers in Castle Rock, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.