KEITH RAPHAEL DORAM (M.D.) – Geriatric Medicine (Internal Medicine) Physician, NPI 1720306756

KEITH RAPHAEL DORAM (M.D.) is a healthcare provider. based in Kokomo, Indiana. specializing in INTERNAL MEDICINE. They hold the professional credentials M.D.. They hold a License No. G052927 (CA). The NPI Number for KEITH RAPHAEL DORAM (M.D.) is 1720306756

Main info

Male
43 Years Of Experience
Accepts Medicare Assignment
Name
KEITH RAPHAEL DORAM (M.D.)
NPI
1720306756
Phone
(765) 236-8888
Address
1907 W Sycamore St
Enumeration Date
14 May 2010
Last Update Date
10 July 2025

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3177083732
Graduation Year
1983 (43 years ago)
PAC ID
5991086985
Group Practice PAC ID
9032471354
Professional Enrollment ID
I20190607001843
Address ID
IN460325885CA12315STXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience78
Completeness85
Years active:16State licenses:4Digital endpointsOther names

3,517 INTERNAL MEDICINE in IN

Provider Addresses for KEITH RAPHAEL DORAM (M.D.)

  • 1907 W Sycamore St

    Kokomo, IN 469015148

    Phone: (765) 236-8888

    Fax: (765) 266-8880

    Type: Location

  • 2015 Jackson St

    Anderson, IN 460164337

    Phone: (765) 683-3213

    Fax: (765) 683-3229

    Type: Location

  • 395 Westfield Rd

    Noblesville, IN 460601425

    Phone: (317) 776-7407

    Fax: (317) 776-7361

    Type: Location

  • 12315 HANCOCK ST STE 24

    CARMEL, IN 460325885

    Phone: (317) 708-3732

    Fax: (888) 316-7962

    Type: Mailing

  • 17300 WESTFIELD BLVD STE 110

    WESTFIELD, IN 460741363

    Phone: (317) 763-1019

    Fax: (317) 763-1082

    Type: Location

  • 2100 Douglas Blvd

    Roseville, CA 956613804

    Phone: (916) 781-4627

    Fax: (916) 783-9909

    Type: Location

  • 441 N Wabash Ave

    Marion, IN 469522612

    Phone: (765) 660-6670

    Fax: (765) 671-3392

    Type: Location

  • 1000 E Main St

    Danville, IN 461221948

    Phone: (317) 718-7971

    Fax: (317) 718-7973

    Type: Location

  • 2001 W 86th St

    Indianapolis, IN 462601902

    Phone: (317) 338-9067

    Fax: (317) 338-9087

    Type: Location

  • 3641 GHISLAINE CT

    ROSEVILLE, CA 957479152

    Phone: (916) 878-0663

    Type: Mailing

  • 2100 DOUGLAS BLVD

    ROSEVILLE, CA 956613804

    Phone: (916) 781-4627

    Fax: (916) 783-9909

    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 $426.

Total Amount is formed as General ($426) + Research ($0) + Ownership ($0) = $426.

Last reported payment date: 2024-11-19 • Largest payer in this snapshot: Smith+Nephew, Inc. ($168).

Total Amount

$426

General + Research + Ownership

Payments

12

Total payment records

General Amount

$426

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2019-06-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170607001366IInternal MedicineOHTBD
I20190607001843IInternal MedicineINTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
11042Removal of skin and tissue, 20.0 sq cm or less303101$0
99214Established patient office or other outpatient visit, 30-39 minutes18780$0
99213Established patient office or other outpatient visit, 20-29 minutes12058$0
99183Management of oxygen chamber therapy10321$0
17250Application of chemical to stop tissue regrowth in wound6127$0
View full utilization report →

Insurance plans in this area (ZIP 46901)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9032471354View full group profile
NameSpecialtyState
Nurse PractitionerIN
Nurse PractitionerIN
Nurse PractitionerIN
General Surgery, Thoracic SurgeryIN
Nurse PractitionerIN
Nurse PractitionerIN

Reviews

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Frequently asked questions

How is KEITH RAPHAEL DORAM (M.D.) identified in CMS data?
CMS-hosted NPPES data lists KEITH RAPHAEL DORAM (M.D.) with NPI 1720306756.
Is KEITH RAPHAEL DORAM (M.D.) still practicing?
KEITH RAPHAEL DORAM (M.D.) is currently listed as active in the public NPI registry.
What taxonomy line describes KEITH RAPHAEL DORAM (M.D.)?
For research purposes, treat KEITH RAPHAEL DORAM (M.D.) as Geriatric Medicine (Internal Medicine) Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does KEITH RAPHAEL DORAM (M.D.) list a practice location?
Patients near Kokomo, Indiana may find KEITH RAPHAEL DORAM (M.D.) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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