Keller Skin & Cancer Care PC
NPI 1649543323ActiveOrganization· Dermatology· Eagle, ID
Dermatology in Eagle, Idaho, registered in NPPES in February 2012. The authorized official on file is Wade Robert Keller, DO, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1649543323 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 11, 2012 |
| Last updated in NPPES | Nov 3, 2022 |
| Certified by provider | Nov 3, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Dermatology | 207N00000X | O-0559 | ID |
| Dermatology, MOHS-Micrographic Surgery | 207ND0101X | — | — |
| Dermatology, Procedural Dermatology | 207NS0135X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (ID) |
|---|
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