KENNETH M KINZIE (M.S.W., LCSW) – Clinical Social Worker, NPI 1104980499

KENNETH M KINZIE (M.S.W., LCSW) is a healthcare provider. based in Sarasota, Florida. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials M.S.W., LCSW. They hold a License No. SW1660 (FL). The NPI Number for KENNETH M KINZIE (M.S.W., LCSW) is 1104980499

Main info

Male
Sole Proprietor
54 Years Of Experience
Accepts Medicare Assignment
Name
KENNETH M KINZIE (M.S.W., LCSW)
NPI
1104980499
Phone
(941) 374-3846
Address
73 S PALM AVE
Enumeration Date
20 December 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8135631155
Graduation Year
1972 (54 years ago)
PAC ID
4284009150
Group Practice PAC ID
4587969977
Professional Enrollment ID
I20230406000342
Address ID
FL336093574TA205XXBLVD401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

3,376 CLINICAL SOCIAL WORKER in FL

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Provider Addresses for KENNETH M KINZIE (M.S.W., LCSW)

  • 73, South Palm Avenue, Sarasota, Sarasota County, Florida, 34236, United States

    SUITE 215

    SARASOTA, FL 342365638

    Phone: (941) 374-3846

    Fax: (941) 751-4885

    Type: Location

  • 6620 QUONSET RD

    BRADENTON, FL 342039730

    Phone: (941) 374-3846

    Fax: (941) 751-4885

    Type: Mailing

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: 2023-04-06

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
I20230406000342IClinical Social WorkerFLTBD

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 34236)

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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: 4587969977View full group profile
NameSpecialtyState
Clinical PsychologistFL
Clinical PsychologistFL
Clinical PsychologistFL
-FL
Clinical PsychologistFL
-FL
Clinical PsychologistFL
Clinical PsychologistFL
Clinical PsychologistFL
Clinical PsychologistFL

Reviews

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Frequently asked questions

What is the registry number for KENNETH M KINZIE (M.S.W., LCSW)?
The registry entry for KENNETH M KINZIE (M.S.W., LCSW) shows NPI 1104980499.
Should I treat KENNETH M KINZIE (M.S.W., LCSW) as an active provider?
Patients and plans typically see KENNETH M KINZIE (M.S.W., LCSW) as active in the national extract.
How should patients interpret KENNETH M KINZIE (M.S.W., LCSW)'s specialty?
The extract shows Clinical Social Worker for KENNETH M KINZIE (M.S.W., LCSW). Clinical services aligned with this taxonomy classification.
What geographic area is tied to KENNETH M KINZIE (M.S.W., LCSW)?
KENNETH M KINZIE (M.S.W., LCSW) is associated with Sarasota, Florida in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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