Individual provider Active NPI

John Robinson Keltner

  • Psychiatry Physician
  • La Jolla, CA
National Provider Identifier
1740447416
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A71514 Issued in CA
Practice address
9500 Gilman Dr
MC: 0603
La Jolla, CA 92093-0603
Phone
(619) 838-0519
NPI assigned
May 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A71514 CA Primary

Addresses

Primary practice location

9500 Gilman Dr
MC: 0603
La Jolla, CA 92093-0603

Mailing address

9500 Gilman Dr
MC: 0603
La Jolla, CA 92093-0603
Phone (619) 838-0519

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131231000151 CA Practitioner - Psychiatry 8729215405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Harvard Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

72650 Fred Waring Dr
Suite 211
Palm Desert, CA 92260-5010
Phone (619) 838-0519

Hospital & facility affiliations

  • Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573

Merit-based Incentive Payment System (MIPS)

Final score
18.08 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
60.28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A71514CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General and Pain Psychiatry Inc CurrentSince Mar 29, 2016 Accepting new patients

Locations

72650 Fred Waring Dr
Ste 211
Palm Desert, CA 92260
Phone (619) 838-0519

36101 Bob Hope Dr
Ste B2
Rancho Mirage, CA 92270
Phone (760) 321-1315

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1740447416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR",
            "address_2": "MC: 0603",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920930603",
            "telephone_number": "619-838-0519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR",
            "address_2": "MC: 0603",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920930603",
            "telephone_number": "619-838-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELTNER",
        "first_name": "JOHN",
        "middle_name": "ROBINSON",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A71514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.