DR. KETTI R BOLLER D.D.S, M.S
NPI 1255682662
Dentist - Orthodontics and Dentofacial Orthopedics in Crown Point, IN
About Dr. Ketti R Boller D.d.s, M.s NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KETTI R BOLLER D.D.S, M.S (NPI 1255682662) is an individual orthodontics and dentofacial orthopedics provider in Crown Point, Indiana, licensed in Indiana (12014618A) and active in the NPI registry since September 2012. She is enrolled in Medicare PECOS and maintains a secondary practice location in Dyer.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Ketti R Boller D.d.s, M.s is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Ketti Boller reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Chicago, IL 60620
- Reassigned Medicare billing, Illinois enrollment
- 2,127 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 46307 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Ketti Boller's NPI number?
The NPI number for Ketti Boller is 1255682662. It was assigned to this individual provider in the NPPES registry on September 25, 2012.
Where is Ketti Boller located?
Ketti Boller practices at 123 N Main St Ste 101, Crown Point, IN 46307. The listed phone number is (219) 663-2000.
What is Ketti Boller's specialty?
The primary specialty registered for this NPI is Dentist, specializing in Orthodontics and Dentofacial Orthopedics, with taxonomy code 1223X0400X.
Is Ketti Boller enrolled in Medicare?
Yes. Ketti Boller is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Ketti Boller's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ketti Boller reassigns Medicare benefits to The Board Of Trustees Of The University Of Illinois (Chicago, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ketti Boller's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Ketti Boller accept?
Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Delta Dental PPO and Delta Dental of Indiana and 1 other insurer list Ketti Boller 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.
When was this NPI record last updated?
The NPPES record for Ketti Boller was last updated on April 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.