Active NPI
Kenneth J Keller, MD
- Diagnostic Radiology Physician
- Scottsdale, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 25985
- Practice address
- 3501 N Scottsdale Rd Ste 130
Scottsdale, AZ 85251-5649 - Phone
- (480) 425-5000
- NPI assigned
- Sep 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 4828 | ND | |
| Diagnostic Radiology Physician | 2085R0202X | 25985 | AZ | Primary |
Addresses
Primary practice location
3501 N Scottsdale Rd Ste 130
Scottsdale, AZ 85251-5649
Mailing address
PO Box 5010
Minot, ND 58702-5010
Phone (701) 857-5650
Other practice location 1
1 Burdick Expy W
Minot, ND 58701-4406
Phone (701) 857-5220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 889470 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090706000168 | TX | Practitioner - Diagnostic Radiology | 5991766206 | |
| I20160215000578 | AZ | Practitioner - Diagnostic Radiology | 5991766206 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of North Dakota School of Medicine, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
19829 N 27TH Ave
Phoenix, AZ 85027-4001
Phone (832) 915-2534
250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone (832) 915-2534
3648 W Anthem Way
Suite A100
Anthem, AZ 85086-7002
Phone (832) 915-2534
6750 E Baywood Ave
Mesa, AZ 85206-1749
Phone (832) 915-2534
7400 E Thompson Peak Pkwy
Scottsdale, AZ 85255-4109
Phone (832) 915-2534
9003 E Shea Blvd
Scottsdale, AZ 85260-6709
Phone (832) 915-2534
9220 E Mountain View Rd
Suite 100
Scottsdale, AZ 85258-5134
Phone (480) 425-5000
Hospital & facility affiliations
- Honorhealth Scottsdale Shea Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4828 | ND | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Diagnostic Imaging LLC | Diagnostic Radiology | Current | Accepting new patients |
| Sonoran Radiology LTD | Diagnostic Radiology | Current | Accepting new patients |
| Quentin N Burdick Comprehensive Health Care Facility | Past | Accepting new patients | |
| Prescott Radiologists LLP | Past | Accepting new patients | |
| Simonmed Imaging, Incorporated | Diagnostic Radiology | Past | Accepting new patients |
Locations (25 of 48)
3648 W Anthem Way
Ste A100
Anthem, AZ 85086
Phone (623) 434-6444
2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200
1076 W Chandler Blvd
Ste 120
Chandler, AZ 85224
Phone (480) 821-9198
16838 E Palisades Blvd
Ste C151
Fountain Hills, AZ 85268
3645 S Rome St
Ste 101
Gilbert, AZ 85297
665 N Gilbert Rd
Ste 154
Gilbert, AZ 85234
Phone (480) 507-4500
5310 W Thunderbird Rd
Ste 100
Glendale, AZ 85306
Phone (602) 978-0892
6220 W Bell Rd
Ste 110
Glendale, AZ 85308
Phone (602) 547-7230
5757 W Thunderbird Rd
Ste W100
Glendale, AZ 85306
Phone (623) 931-7999
5605 W Eugie Ave
Ste 110
Glendale, AZ 85304
Phone (602) 938-2002
18275 N 59th Ave
Ste 168K
Glendale, AZ 85308
Phone (602) 889-1977
5601 W Eugie Ave
Ste 102
Glendale, AZ 85304
Phone (602) 588-3420
13555 W McDowell Rd
Ste 106
Goodyear, AZ 85395
Phone (623) 535-0917
1052 E McKellips Rd
Mesa, AZ 85203
Phone (480) 425-5080
6750 E Baywood Ave
Mesa, AZ 85206
Phone (480) 854-5000
6553 E Baywood Ave
Ste 102
Mesa, AZ 85206
Phone (480) 268-7600
6424 E Broadway Rd
Ste 101
Mesa, AZ 85206
Phone (602) 830-0619
1450 S Dobson Rd
Ste A100
Mesa, AZ 85202
Phone (480) 545-9779
10575 N Tatum Blvd
Ste C128
Paradise Vly, AZ 85253
Phone (480) 998-1490
10230 W Happy Valley Pkwy
Ste 100
Peoria, AZ 85383
Phone (623) 266-4699
2323 W Rose Garden Ln
Phoenix, AZ 85027
Phone (623) 931-7999
2222 E Highland Ave
Ste 120
Phoenix, AZ 85016
Phone (602) 977-1177
33423 N 32nd Ave
Phoenix, AZ 85085
Phone (623) 474-1600
20940 N Tatum Blvd
Ste 390
Phoenix, AZ 85050
Phone (480) 407-0060
18404 N Tatum Blvd
Ste 103
Phoenix, AZ 85032
Phone (602) 485-7490
Organizations & group practices 5
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.
-
- Vascular & Interventional Radiology Physician
- Mesa, AZ
- NPI 1033745708
AZ, Diagnostic Radiology
-
- Diagnostic Radiology Physician
- Scottsdale, AZ
- NPI 1902896236
AZ, Diagnostic Radiology
-
- Specialist
- Prescott, AZ
- NPI 1689636243
-
- Diagnostic Radiology Physician
- Scottsdale, AZ
- NPI 1164460077
Diagnostic Radiology
-
- Pharmacist
- Belcourt, ND
- NPI 1245754548
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": "1127433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550448000000",
"number": "1891781886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5010",
"city": "MINOT",
"state": "ND",
"postal_code": "587025010",
"telephone_number": "701-857-5650",
"fax_number": "701-857-5031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 N SCOTTSDALE RD STE 130",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852515649",
"telephone_number": "480-425-5000"
}
],
"practiceLocations": [
{
"address_1": "1 Burdick Expy W",
"address_purpose": "LOCATION",
"city": "Minot",
"state": "ND",
"postal_code": "587014406",
"country_code": "US",
"telephone_number": "701-857-5220",
"fax_number": "701-857-5245",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KELLER",
"first_name": "KENNETH",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-23",
"last_updated": "2019-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "ND",
"license": "4828",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "AZ",
"license": "25985",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "889470",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; 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.