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DR. ROBERT LOUIS KETCHAM D.D.S., M.S.D
NPI 1841317518
Dentist - Prosthodontics in Fort Wayne, IN

Active since March 26, 2007Opted out of Medicare · through Oct 1, 2026
1120 E DUPONT RD, FORT WAYNE, IN 46825(260) 497-0497(260) 489-4853 Get Directions Write a Review

NPPES record last updated: May 27, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Robert Louis Ketcham D.d.s., M.s.d NPPES

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

DR. ROBERT LOUIS KETCHAM D.D.S., M.S.D (NPI 1841317518) is an individual prosthodontics provider in Fort Wayne, Indiana, licensed in Indiana (12006504A) and active in the NPI registry since March 2007. He has opted out of Medicare through October 1, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1841317518
Entity TypeIndividualMale
Primary Taxonomy1223P0700X
Provider Legal NameDR. ROBERT LOUIS KETCHAMCredential: D.D.S., M.S.D
Location Address1120 E DUPONT RDFort Wayne, IN 46825-1556
Mailing Address1120 E Dupont RdFort Wayne, IN 46825-1556 · (260) 497-0497 · Fax (260) 489-4853
Phone(260) 497-0497
Fax(260) 489-4853
Sole ProprietorNo
Enumeration DateMarch 26, 2007
Last NPPES UpdateMay 27, 2008
✔ NPI 1841317518 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · ProsthodonticsDental Providers
Taxonomy Code1223P0700X
License✔ Licensed in IN · 12006504A
Definition
That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
1120 E DUPONT RD, Fort Wayne, IN 46825
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Other Identifiers 1

Medicare UPIN136030

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Robert Louis Ketcham D.d.s., M.s.d has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2014 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2014
Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46825 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
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

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

ORTHODONTIC SPECIALTY SERVICES, INC.
Dentist (Orthodontics and Dentofacial Orthopedics)
1120 E DUPONT RD
FORT WAYNE, IN 46825
Allen County (260) 497-0497
DR. ERIC LEE DELLINGER D.D.S., M.S.D.
Dentist (Orthodontics and Dentofacial Orthopedics)
1120 E DUPONT RD
FORT WAYNE, IN 46825
Allen County (260) 497-0497
DR. ARON E DELLINGER D.D.S., M.S.D.
Dentist (Orthodontics and Dentofacial Orthopedics)
1120 E DUPONT RD
FORT WAYNE, IN 46825
Allen County (260) 497-0497

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 Robert Ketcham's NPI number?

The NPI number for Robert Ketcham is 1841317518. It was assigned to this individual provider in the NPPES registry on March 26, 2007.

Where is Robert Ketcham located?

Robert Ketcham practices at 1120 E Dupont Rd, Fort Wayne, IN 46825. The listed phone number is (260) 497-0497.

What is Robert Ketcham's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Prosthodontics, with taxonomy code 1223P0700X.

Is Robert Ketcham enrolled in Medicare?

No. Robert Ketcham has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Robert Ketcham was last updated on May 27, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.