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THEPPANYA KA KEOLASY MD
NPI 1124028881
Family Medicine in Roanoke, IN

Active since July 26, 2005PECOS EnrolledAccepts Medicare Assignment
81.23/100
CMS Quality Rating
577 GEIGER DR STE C, ROANOKE, IN 46783(260) 672-5950(260) 672-0939 Get Directions Write a Review

NPPES record last updated: December 22, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Theppanya Ka Keolasy Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THEPPANYA KA KEOLASY MD (NPI 1124028881) is an individual family medicine provider in Roanoke, Indiana, licensed in Indiana (01058795A) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Parkview Regional Medical Center, and is a graduate of Indiana University School Of Medicine (2001).

NPPES Registry Identity

NPI1124028881
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameTHEPPANYA KA KEOLASYCredential: MD
Location Address577 GEIGER DR STE CRoanoke, IN 46783-8877
Mailing Address11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701
Phone(260) 672-5950
Fax(260) 672-0939
Sole ProprietorNo
Medical School CMSIndiana University School Of MedicineGraduated 2001
Enumeration DateJuly 26, 2005
Last NPPES UpdateDecember 22, 2022
NPPES CertifiedDecember 22, 2022
✔ NPI 1124028881 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IN · 01058795A
Definition
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.
577 GEIGER DR STE C, Roanoke, IN 46783
Open in Google Maps ↗

Other Identifiers 3

Other000000655775IN · Anthem
Medicaid200502100AIN
Medicaid200956680IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Theppanya Ka Keolasy Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5597731794
PECOS Enrollment IDI20040909000023
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
307 services185 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
103 services103 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
101 services90 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
101 services81 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
70 services43 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
60 services60 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Parkview Regional Medical Center

Acute Care Hospitals · Fort Wayne, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150021
Location11109 Parkview Plaza DriveFort Wayne, IN 46845 · Allen County
Emergency services Birthing friendly

Parkview Huntington Hospital

Acute Care Hospitals · Huntington, IN
OwnershipVoluntary non-profit - Private
CMS Certification Number150091
Location2001 Stults RdHuntington, IN 46750 · Huntington County
Emergency services Birthing friendly

Parkview Wabash Hospital, Inc

Critical Access Hospitals · Wabash, IN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number151310
Location10 John Kissinger DriveWabash, IN 46992 · Wabash County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46783 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.23/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.95
Promoting Interoperability100
Improvement Activities40
Cost68.49

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
7 suppliers23 claims54 services$5.99 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier15 claims15 services$99.22 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$35.00 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEGAN MARIE SALZMANN
Physician Assistant
577 GEIGER DR STE C
ROANOKE, IN 46783
Huntington County (260) 425-6750
SHERRI LYNN ANDERSON NP
Nurse Practitioner
577 GEIGER DR STE C
ROANOKE, IN 46783
Huntington County (260) 672-5950

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theppanya Keolasy's NPI number?

The NPI number for Theppanya Keolasy is 1124028881. It was assigned to this individual provider in the NPPES registry on July 26, 2005.

Where is Theppanya Keolasy located?

Theppanya Keolasy practices at 577 Geiger Dr Ste C, Roanoke, IN 46783. The listed phone number is (260) 672-5950.

What is Theppanya Keolasy's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Theppanya Keolasy enrolled in Medicare?

Yes. Theppanya Keolasy is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Theppanya Keolasy accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Theppanya Keolasy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Theppanya Keolasy affiliated with any hospitals?

According to CMS data, Theppanya Keolasy is affiliated with Parkview Regional Medical Center, Parkview Huntington Hospital and Parkview Wabash Hospital, Inc.

When was this NPI record last updated?

The NPPES record for Theppanya Keolasy was last updated on December 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.