NPIMap

Individual provider Active NPI

Duke Keller, D.O

  • Emergency Medicine Physician
  • Mesa, AZ
National Provider Identifier
1760825566
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
007356 Issued in AZ
Practice address
6644 E Baywood Ave
Mesa, AZ 85206-1747
Phone
(480) 321-2000
NPI assigned
Apr 10, 2013
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X SH848782 OH
Emergency Medicine Physician 207P00000X 5315066555 MI
Emergency Medicine Physician 207P00000X 007356 AZ Primary

Addresses

Primary practice location

6644 E Baywood Ave
Mesa, AZ 85206-1747

Mailing address

4720 E Clarendon Ave
Phoenix, AZ 85018-6016

Other practice location 1

100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone (616) 391-1680

Other names 1

  • David Keller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170714001600 AZ Practitioner - Emergency Medicine 5991921496 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tec Emergency Physicians of Arizona, LLCGroup PAC ID 6204256084, 155 clinicians

Practice addresses (Care Compare)

4760 E Germann Rd
Gilbert, AZ 85297-0205
Phone (888) 732-3317

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5315066555MIMDEmergency Medicine Physician
SH848782OHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Tec Emergency Physicians of Arizona, LLC CurrentSince Sep 23, 2020 Accepting new patients
Quantum Healthcare Medical Associates of Arizona, PC Emergency Medicine CurrentSince Jul 24, 2017 Accepting new patients
Emergency Physicians Southwest, PC Emergency Medicine CurrentSince Jul 24, 2017 Accepting new patients

Locations

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

4760 E Germann Rd
Gilbert, AZ 85297
Phone (480) 494-5000

1910 S Gilbert Rd
Mesa, AZ 85204
Phone (480) 410-6150

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

1419 W Hunt Hwy
San Tan Vly, AZ 85143
Phone (480) 245-4300

5125 S Rural Rd
Tempe, AZ 85282
Phone (480) 306-8780

Organizations & group practices 3

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.

Hospital & facility affiliations 9

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": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1760825566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 E CLARENDON AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850186016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6644 E BAYWOOD AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061747",
            "telephone_number": "480-321-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Michigan St NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032560",
            "country_code": "US",
            "telephone_number": "616-391-1680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLER",
        "first_name": "DUKE",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "SH848782",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5315066555",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "007356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "KELLER",
            "credential": "D.O",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.