Individual provider Active NPI

Melinda C Keller, DC

  • Chiropractor
  • Brooklyn, NY
National Provider Identifier
1972550887
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X002968-1 Issued in NY
Practice address
5911 16TH Ave
Brooklyn, NY 11204-2114
Phone
(718) 234-6200
Fax
(718) 234-6210
NPI assigned
May 27, 2006
Last updated
Oct 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X002968-1 NY Primary

Addresses

Primary practice location

5911 16TH Ave
Brooklyn, NY 11204-2114

Mailing address

5911 16TH Ave
Brooklyn, NY 11204-2114
Phone (718) 234-6200

Other identifiers 6

IdentifierTypeStateIssuer
P2103354OtherNYOXFORD
X7P121OtherNYBLUE CROSS BLUE SHIELD
02568041MedicaidNY
5897420OtherNYGHI
100063047901OtherNYAMERICHOICE
166252OtherNYELDERPLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050906000225 NY Practitioner - Chiropractic 3870525421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1514 60TH St
Suite 308
Brooklyn, NY 11219-5022
Phone (718) 234-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X002968-1NYMDChiropractor
002968NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brooklyn Spine Chiropractic PC Chiropractor CurrentSince Jun 30, 2009 Accepting new patients
Keller Chiropractic of Crown Heights LLC. Chiropractor Past Accepting new patients
Keller Chiropractic of Williamsburg LLC. Chiropractor PastSince Feb 29, 2008 Accepting new patients

Locations

1514 60th St
Ste 308
Brooklyn, NY 11219
Phone (718) 234-6200

5911 16th Ave
Brooklyn, NY 11204
Phone (718) 232-2300

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.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1972550887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5911 16TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042114",
            "telephone_number": "718-234-6200",
            "fax_number": "718-234-6210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 16TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042114",
            "telephone_number": "718-234-6200",
            "fax_number": "718-234-6210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "MELINDA",
        "middle_name": "C",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X002968-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2103354",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "X7P121",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02568041",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "5897420",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "100063047901",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDERPLAN",
            "identifier": "166252",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.