Mr John W Keller, PHD is a medicare enrolled "Psychologist" provider in Destin, Florida. His current practice location is
215 Mountain Dr, Ste. 106, Destin, Florida. You can reach out to his office (for appointments etc.) via phone at
(850) 837-9100.
Mr John W Keller is licensed to practice in Florida (license number PY2338) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1043248800.
Healthcare Provider's Profile
| Full Name | Mr John W Keller |
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| Gender | Male |
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| Speciality | Psychologist |
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| Location | 215 Mountain Dr, Destin, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1043248800
- Provider Enumeration Date: 06/29/2006
- Last Update Date: 06/22/2011
Medicare PECOS Information:
- PECOS PAC ID: 6002867322
- Enrollment ID: I20050203000728
Medical Identifiers
Medical identifiers for Mr John W Keller such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043248800 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | PY2338 (Florida) | Secondary |
| 103T00000X | Psychologist | PY2338 (Florida) | 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. Mr John W Keller allows following entities to bill medicare on his behalf.
| Entity Name | Emerald Coast Counseling Center Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1831174705
PECOS PAC ID: 9032100839
Enrollment ID: O20040520000787 |
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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. Mr John W 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 |
|---|
Mr John W Keller, PHD
215 Mountain Dr, Ste. 106,
Destin, FL 32541-2346
Ph: (850) 837-9100 | Mr John W Keller, PHD
215 Mountain Dr, Ste. 106,
Destin, FL 32541-2346
Ph: (850) 837-9100 |
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