DR. SCOTT T KELLER DO
NPI 1609861830
Family Medicine in Lilburn, GA
NPI Status: Active since September 14, 2005
Contact Information
4120 FIVE FORKS TRICKUM RD SW
SUITE 105
LILBURN, GA
ZIP 30047
Phone: (770) 921-6900
Fax: (770) 921-6313
- Individual
- Male
- Years of Experience 47
- Family Medicine
- Accepts Medicare Approved Payment
- PECOS Enrolled
About SCOTT KELLER
This page provides the complete NPI Profile along with additional information for Scott Keller, a primary care provider established in Lilburn, Georgia with a medical specialization in Family Medicine and more than 47 years of experience. He graduated from West Virginia School Of Osteopathic Medicine in 1979. The healthcare provider is registered in the NPI registry with number 1609861830 assigned on September 2005. The practitioner's primary taxonomy code is 207Q00000X with license number 024445 (GA). The provider is registered as an individual and his NPI record was last updated 18 years ago.
- NPI
- 1609861830
- Provider Name
- DR. SCOTT T KELLER DO
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4120 FIVE FORKS TRICKUM RD SW SUITE 105 LILBURN, GA 30047
- Location Phone
- (770) 921-6900
- Location Fax
- (770) 921-6313
- Mailing Address
- 4120 FIVE FORKS TRICKUM RD SW SUITE 105 LILBURN, GA 30047
- Mailing Phone
- (770) 921-6900
- Mailing Fax
- (770) 921-6313
- Medical School Name
- WEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE
- Graduation Year
- 1979
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-14-2005
- Last Update Date
- 10-30-2007
- Code Navigator
A primary care provider (PCP) like Scott Keller sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 024445
- License State
- GA
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
Identifier | Type / Code | Identifier State | Identifier Issuer |
---|---|---|---|
E89431 | MEDICARE UPIN (02) | GA | |
00275272D | MEDICAID (05) | GA | |
08LCBCT | MEDICARE PIN (08) | GA |
Medicare Participation & PECOS Enrollment Status
Scott Keller is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Scott Keller is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 7214036656
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20070626000136
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Oxygen and Supplies (DC002N)
Portable oxygen concentrator, rental (HCPCS:E1392)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $22.01 for a new patient copayment and $25.05 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 30047 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $88.06
- Minimum New Patient Price $56.84
- Maximum New Patient Price $172.43
- Average New Patient Copayment $22.01
- Minimum New Patient Copayment $14.21
- Maximum New Patient Copayment $43.1
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $100.2
- Minimum Established Patient Price $18.22
- Maximum Established Patient Price $140.4
- Average Established Patient Copayment $25.05
- Minimum Established Patient Copayment $4.55
- Maximum Established Patient Copayment $35.1
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Scott Keller is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
NORTHSIDE HOSPITAL FORSYTH | 1200 NORTHSIDE FORSYTH DRIVE CUMMING, GA 30041 | (770) 844-3200 | Acute Care Hospitals | |
NORTHSIDE HOSPITAL GWINNETT | 1000 MEDICAL CENTER BOULEVARD LAWRENCEVILLE, GA 30046 | (678) 312-1000 | Acute Care Hospitals | |
PIEDMONT EASTSIDE MEDICAL CENTER | 1700 MEDICAL WAY SNELLVILLE, GA 30078 | (770) 979-0200 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 6 | 0 | 9 | 8 | 6 | 1 | 8 | 3 | 0 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 6 | 0 | 9 | 16 | 6 | 2 | 8 | 6 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 6 + 0 + 9 + 1 + 6 + 6 + 2 + 8 + 6 + 24 = 70 | |||||||||
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
0 |
The NPI number 1609861830 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 11 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1891737425 | GREATER GWINNETT PHYSICIAN PRACTICE COMPANY Organization | Family Medicine | 4120 FIVE FORKS TRICKUM RD SW SUITE 105 LILBURN, GA 30047 (770) 921-6900 |
1720192925 | WILLIAM J ANDERSON M. D. Individual | Family Medicine | 4120 FIVE FORKS TRICKUM RD SW LILBURN, GA 30047 (770) 935-9546 |
1013021229 | DEAN S ATTAWAY M. D. Individual | Family Medicine | 4120 FIVE FORKS TRICKUM RD SW LILBURN, GA 30047 (770) 935-9546 |
1902061864 | KELLEY SUE WHARTON NP Individual | Nurse Practitioner (Family) | 4120 FIVE FORKS TRICKUM RD SW SUITE 105 LILBURN, GA 30047 (770) 921-6900 |
1528469426 | GWINNETT PEDIATRIC PARTNERS, INC Organization | Pediatrics | 4120 FIVE FORKS TRICKUM RD SW STE 102 LILBURN, GA 30047 (770) 923-6400 |
1750446969 | DR. ROBERT CLARK FRANTZ D.O. Individual | Family Medicine | 4120 FIVE FORKS TRICKUM RD SW STE 105 LILBURN, GA 30047 (770) 921-6900 |
1588824346 | TASLIMA BHUIYAN MD Individual | Internal Medicine (Cardiovascular Disease) | 4120 FIVE FORKS TRICKUM RD SW SUITE 103 LILBURN, GA 30047 (770) 255-3491 |
1598971780 | MOUNTAIN EAST FAMILY MEDICINE PC Organization | Family Medicine | 4120 FIVE FORKS TRICKUM RD SW SUITE 105 LILBURN, GA 30047 (770) 921-6900 |
1467958389 | EUNMI HUR MD Individual | Family Medicine | 4120 FIVE FORKS TRICKUM RD SW LILBURN, GA 30047 (770) 935-9546 |
1780188359 | LISA CALHOUN CPNP Individual | Nurse Practitioner | 4120 FIVE FORKS TRICKUM RD SW LILBURN, GA 30047 (770) 923-6400 |
1043037278 | SANA ALI NP Individual | Nurse Practitioner (Family) | 4120 FIVE FORKS TRICKUM RD SW LILBURN, GA 30047 (770) 255-3491 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1609861830, enumerated in the NPI registry as an "individual" on September 14, 2005
The provider is located at 4120 Five Forks Trickum Rd Sw Suite 105 Lilburn, Ga 30047 and the phone number is (770) 921-6900
The provider's speciality is Family Medicine with taxonomy code 207Q00000X
The provider has more than 47 years of experience. He graduated from West Virginia School Of Osteopathic Medicine in 1979.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $88.06 with an average copayment of $22.01 for new patient appointments. Established patients should expect a typical charge of $100.2 and an average copayment of 25.05. Please review your insurance plan or contact the provider directly to determine your specific costs.
The practitioner is affiliated to the following hospital(s): NORTHSIDE HOSPITAL FORSYTH, NORTHSIDE HOSPITAL GWINNETT and PIEDMONT EASTSIDE MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on September 14, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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