Todd Michael Keppich, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG002045 Issued in PA

Practice address

2121 Shelly Dr
Indiana, PA 15701-2395

Phone

(724) 349-1237

Fax

(724) 465-0127

NPI assigned

Nov 7, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cowburn and Keppich LLCGroup PAC ID 0547588972, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tkeppich@direct.revolutionehr.com

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.

• Cowburn and Keppich LLC

  • Optometrist
  • Vandergrift, PA
  • NPI 1275925349
  Medicare reassignment Care Compare group NPD
• Ryan William Cowburn, O.D.

  • Optometrist
  • Indiana, PA
  • NPI 1669487252

  PA

  Medicare reassignment
• Joseph J. Raglani, O.D.

  • Eyewear Supplier
  • Vandergrift, PA
  • NPI 1902084718
  NPD (past)
• Ryan W Cowburn OD

  • Optometrist
  • Indiana, PA
  • NPI 1437319944
  NPD (past)

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1922089101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 SHELLY DR",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157012395",
            "telephone_number": "724-349-1237",
            "fax_number": "724-465-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 SHELLY DR",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157012395",
            "telephone_number": "724-349-1237",
            "fax_number": "724-465-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPPICH",
        "first_name": "TODD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0601800384",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "0601800384",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "OEG002045",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beca-Lin Marie Kelly
• Jessica Kelly, AUD
• Michelle Kelly, RDN, LD
• Christina Marie Kemerer, PA-C
• Jennifer Diane Keough, BSW
• Brianna Kerr, PA-C
• Keystone Rehabilitation Systems Inc
• Laurie Lynn Khalouf-Rahuba, M.A.
• Aimal Khan, MD
• Amanda Kilburn, DO

• All providers in Indiana, PA
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; 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.

Verify at the official NPI Registry.