DR. WADE ROBERT KELLER (D.O.) – Dermatology Physician, NPI 1942402169
Dermatology Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
9 MICROGRAPHIC DERMATOLOGIC SURGERY (MDS) in ID
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Provider Addresses for DR. WADE ROBERT KELLER (D.O.)
1605 E RVERSIDE DRIVE
EAGLE, ID 83616
Phone: (208) 939-6227
Fax: (208) 939-6442
Type: Mailing
East Riverside Drive, Eagle, Ada County, Idaho, 83616, United States
EAGLE, ID 836166237
Phone: (208) 939-6227
Fax: (208) 939-6442
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 12 Open Payments records for all available years, with a total value of $402.
Total Amount is formed as General ($402) + Research ($0) + Ownership ($0) = $402.
Last reported payment date: 2024-08-21 • Largest payer in this snapshot: GENZYME CORPORATION ($189).
Total Amount
$402
General + Research + Ownership
Payments
12
Total payment records
General Amount
$402
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GENZYME CORPORATION | $189 |
| UCB, Inc. | $162 |
| ABBVIE INC. | $36 |
| Dermavant Sciences, Inc. | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-06-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100622000581 | I | Micrographic Dermatologic Surgery (Mds) | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 646 | 90 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 260 | 157 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 173 | 117 | $0 |
| 17311 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks | 66 | 64 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 38 | 33 | $0 |
Insurance plans in this area (ZIP 83616)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | ID | 13132 | Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 35 | 35 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | ID | |
| Physician Assistant | ID | |
| Physician Assistant | ID |
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