DR. MAIA KIRSTEN KELLER (MD) – Dermatology Physician, NPI 1124695671
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
125 DERMATOLOGY in IA
Provider Addresses for DR. MAIA KIRSTEN KELLER (MD)
1415 WOODLAND AVE STE 140
DES MOINES, IA 503093203
Phone: (515) 241-8595
Fax: (515) 241-4080
Type: Mailing
3290 N WELLNESS DR STE 240
HOLLAND, MI 494247261
Phone: (616) 395-9379
Fax: (616) 257-1491
Type: Location
1415 Woodland Ave Ste 140
Des Moines, IA 503093203
Phone: (515) 241-8595
Fax: (515) 241-4080
Type: Location
3434 RIVERTOWN POINT CT SW
GRANDVILLE, MI 494183076
Phone: (616) 257-3344
Fax: (616) 457-1491
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2025-08-15
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 |
|---|---|---|---|---|
| I20250815001596 | I | Dermatology | MI | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 50309)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | MI | |
| D E R M A T O L O G Y | MI | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| D E R M A T O L O G Y | MI | |
| D E R M A T O L O G Y | MI | |
| Micrographic Dermatologic Surgery (Mds), Dermatology | MI | |
| - | MI | |
| Physician Assistant | MI |
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