Individual provider Active NPI

Patrick Raymond Keller, MD

  • Plastic and Reconstructive Surgery Physician
  • Baltimore, MD
National Provider Identifier
1821558230
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
25MA13004100 Issued in NJ
Practice address
601 N. Caroline Street
Jhoc 8152C
Baltimore, MD 21287-0006
Phone
(518) 878-6703
NPI assigned
Mar 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 25MA13004100 NJ Primary

Addresses

Primary practice location

601 N. Caroline Street
Jhoc 8152C
Baltimore, MD 21287-0006

Mailing address

1 W Ridgewood Ave Ste 110
Paramus, NJ 07652-2361
Phone (201) 444-9522

Other practice location 1

1 W Ridgewood Ave Ste 110
Paramus, NJ 07652-2361
Phone (201) 444-9522

Other practice location 2

1800 Orleans St
Baltimore, MD 21287-0010
Phone (410) 502-2037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20190702000323 MD Order and Referring Only - Plastic and Reconstructive SurgeryPractitioner - Plastic and Reconstructive Surgery 2264766815

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA13004100NJMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Breslow Center for Plastic Surgery Plastic and Reconstructive Surgery PastSince Jun 15, 2005 Accepting new patients
Bergen Women'S Health and Wellness, LLC PastSince Jul 1, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pkeller91528@direct.mdmercy.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1821558230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W RIDGEWOOD AVE STE 110",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522361",
            "telephone_number": "201-444-9522",
            "fax_number": "201-444-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N. CAROLINE STREET",
            "address_2": "JHOC 8152C",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870006",
            "telephone_number": "518-878-6703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 W Ridgewood Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Paramus",
            "state": "NJ",
            "postal_code": "076522361",
            "country_code": "US",
            "telephone_number": "201-444-9522",
            "fax_number": "201-444-9277",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 Orleans St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870010",
            "country_code": "US",
            "telephone_number": "410-502-2037",
            "fax_number": "410-955-0737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLER",
        "first_name": "PATRICK",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NJ",
            "license": "25MA13004100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.