KEITH ELLIOTT DECKER – Clinical Social Worker, NPI 1063979011

KEITH ELLIOTT DECKER is a healthcare provider. based in Saint louis, Missouri. specializing in CLINICAL SOCIAL WORKER. They hold a License No. 2008005851 (MO). The NPI Number for KEITH ELLIOTT DECKER is 1063979011

Main info

Male
22 Years Of Experience
Accepts Medicare Assignment
Name
KEITH ELLIOTT DECKER
NPI
1063979011
Phone
(314) 206-3700
Address
1430 OLIVE ST STE 400
Enumeration Date
26 February 2019
Last Update Date
12 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5737565353
Graduation Year
2004 (22 years ago)
PAC ID
3678907110
Group Practice PAC ID
1153225271
Professional Enrollment ID
I20191216003101
Address ID
MO636401955FA1085XSTXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:7State licenses:1Digital endpointsOther names

1,245 CLINICAL SOCIAL WORKER in MO

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Provider Addresses for KEITH ELLIOTT DECKER

  • 400, Olive Street, Downtown, City of Saint Louis, Missouri, 63102, United States

    SAINT LOUIS, MO 631032303

    Phone: (314) 206-3700

    Type: Mailing

  • 3309 S KINGSHIGHWAY BLVD

    SAINT LOUIS, MO 631391101

    Phone: (314) 206-3700

    Type: Mailing

  • 4249, Clayton Avenue, Central West End, City of Saint Louis, Missouri, 63110, United States

    SAINT LOUIS, MO 631101718

    Phone: (314) 206-3700

    Type: Location

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: 2019-12-16

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20191216003101IClinical Social WorkerMOTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63103)

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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: 1153225271View full group profile
NameSpecialtyState
Clinical Social WorkerMO
P S Y C H I A T R YMO
Clinical Social WorkerMO
Mental Health CounselorMO
P S Y C H I A T R YMO
Clinical Social WorkerMO
Mental Health CounselorMO
P S Y C H I A T R YOH
Clinical Social WorkerMO
Clinical Social WorkerVA

Reviews

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Frequently asked questions

What identifier follows KEITH ELLIOTT DECKER across health systems?
The NPI 1063979011 uniquely identifies KEITH ELLIOTT DECKER in U.S. healthcare data.
Should I treat KEITH ELLIOTT DECKER as an active provider?
Patients and plans typically see KEITH ELLIOTT DECKER as active in the national extract.
Which specialty label fits KEITH ELLIOTT DECKER?
NPPES ties KEITH ELLIOTT DECKER to Clinical Social Worker in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to KEITH ELLIOTT DECKER?
KEITH ELLIOTT DECKER is associated with Saint Louis, Missouri in the same public data insurers reference.
Why is information missing for KEITH ELLIOTT DECKER?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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