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JOHN JAY KELLER DDS
NPI 1952350738
Dentist - Oral and Maxillofacial Surgery in Sheboygan, WI

Active since May 09, 2006Opted out of Medicare · through Dec 27, 2026
3637 WILGUS AVENUE, SHEBOYGAN, WI 53081(920) 458-8213(920) 459-9797 Get Directions Write a Review

NPPES record last updated: January 6, 2009. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About John Jay Keller Dds NPPES

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

JOHN JAY KELLER DDS (NPI 1952350738) is an individual oral and maxillofacial surgery provider in Sheboygan, Wisconsin, licensed in Wisconsin (5001980) and active in the NPI registry since May 2006. He has opted out of Medicare through December 27, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1952350738
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameJOHN JAY KELLERCredential: DDS
Location Address3637 WILGUS AVENUESheboygan, WI 53081
Mailing Address3637 Wilgus AvenueSheboygan, WI 53081 · (920) 458-8213 · Fax (920) 459-9797
Phone(920) 458-8213
Fax(920) 459-9797
Sole ProprietorNo
Enumeration DateMay 9, 2006
Last NPPES UpdateJanuary 6, 2009
✔ NPI 1952350738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in WI · 5001980
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
3637 WILGUS AVENUE, Sheboygan, WI 53081
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Other Identifiers 3

Medicare UPINT62386
Medicaid33371300WI
Medicare ID-Type Unspecified79744WI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

John Jay Keller Dds 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 December 27, 2022 through December 27, 2026.

Opt-Out Effective DateDecember 27, 2022
Opt-Out In Effect ThroughDecember 27, 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 53081 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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 2

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

THEODORE MICHAEL ANDERSON DMD
Dentist (Oral and Maxillofacial Surgery)
3637 WILGUS AVENUE
SHEBOYGAN, WI 53081
Sheboygan County (920) 458-8213
WADE THOMAS SCHULTZ DDS MD
Dentist (Oral and Maxillofacial Surgery)
3637 WILGUS AVENUE
SHEBOYGAN, WI 53081
Sheboygan County (920) 458-8213

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 John Keller's NPI number?

The NPI number for John Keller is 1952350738. It was assigned to this individual provider in the NPPES registry on May 9, 2006.

Where is John Keller located?

John Keller practices at 3637 Wilgus Avenue, Sheboygan, WI 53081. The listed phone number is (920) 458-8213.

What is John Keller's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is John Keller enrolled in Medicare?

No. John Keller has opted out of Medicare through December 27, 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 John Keller was last updated on January 6, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.