Dr Ketti R Boller, DDS, MS - Medicare Dentist in Crown Point, IN

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Dr Ketti R Boller, DDS, MS is a medicare enrolled "Dentist - Orthodontics And Dentofacial Orthopedics" provider in Crown Point, Indiana. Her current practice location is 123 N Main St Ste 101, Crown Point, Indiana. You can reach out to her office (for appointments etc.) via phone at (219) 663-2000.

Dr Ketti R Boller is licensed to practice in Indiana (license number 12014618A) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1255682662.

Contact Information

Dr Ketti R Boller, DDS, MS
123 N Main St Ste 101,
Crown Point, IN 46307-4077
(219) 663-2000
(219) 322-7667

Map and Direction




Healthcare Provider's Profile

Full NameDr Ketti R Boller
GenderFemale
SpecialityDentist - Orthodontics And Dentofacial Orthopedics
Location123 N Main St Ste 101, Crown Point, Indiana
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1255682662
  • Provider Enumeration Date: 09/25/2012
  • Last Update Date: 04/17/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 0042458648
  • Enrollment ID: I20130521000062

Medical Identifiers

Medical identifiers for Dr Ketti R Boller such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1255682662NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223X0400XDentist - Orthodontics And Dentofacial Orthopedics 12014618A (Indiana)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Ketti R Boller allows following entities to bill medicare on her behalf.
Entity NameThe Board Of Trustees Of The University Of Illinois
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1386863819
PECOS PAC ID: 3072422716
Enrollment ID: O20031112000158

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Ketti R Boller is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Ketti R Boller, DDS, MS
123 N Main St Ste 101,
Crown Point, IN 46307-4077

Ph: (219) 663-2000		Dr Ketti R Boller, DDS, MS
123 N Main St Ste 101,
Crown Point, IN 46307-4077

Ph: (219) 663-2000

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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