Dr Wade Robert Keller, DO is a medicare enrolled "Dermatology" physician in Eagle, Idaho. He went to Arizona College Of Osteopathic Medicine Mid Western University and graduated in 2005 and has 19 years of diverse experience with area of expertise as Micrographic Dermatologic Surgery (mds). He is a member of the group practice Keller Skin And Cancer Care Pc and his current practice location is
1605 E Riverside Dr, Eagle, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 939-6227.
Dr Wade Robert Keller is licensed to practice in Idaho (license number O-0559) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1942402169.
Physician's Profile
| Full Name | Dr Wade Robert Keller |
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| Gender | Male |
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| Speciality | Micrographic Dermatologic Surgery (mds) |
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| Experience | 19 Years |
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| Location | 1605 E Riverside Dr, Eagle, Idaho |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Wade Robert Keller attended and graduated from Arizona College Of Osteopathic Medicine Mid Western University in 2005
NPI Data:
- NPI Number: 1942402169
- Provider Enumeration Date: 06/01/2007
- Last Update Date: 11/03/2022
Medicare PECOS Information:
- PECOS PAC ID: 5698806578
- Enrollment ID: I20100622000581
Medical Identifiers
Medical identifiers for Dr Wade Robert Keller such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1942402169 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | 4692 (Arizona) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | O-0559 (Idaho) | Secondary |
| 207NS0135X | Dermatology - Procedural Dermatology | O-0559 (Idaho) | Secondary |
| 207N00000X | Dermatology | O-0559 (Idaho) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Keller Skin And Cancer Care Pc | 2769647759 | 4 |
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 Wade Robert Keller allows following entities to bill medicare on his behalf.
| Entity Name | Keller Skin & Cancer Care Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1649543323
PECOS PAC ID: 2769647759
Enrollment ID: O20120625000433 |
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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 Wade Robert Keller 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 Address | Practice Location Address |
|---|
Dr Wade Robert Keller, DO
1605 E Rverside Drive,
Eagle, ID 83616
Ph: (208) 939-6227 | Dr Wade Robert Keller, DO
1605 E Riverside Dr,
Eagle, ID 83616-6237
Ph: (208) 939-6227 |
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