MR. KEITH A BERENS (PAC) – Surgical Physician Assistant, NPI 1174505788
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
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Provider Addresses for MR. KEITH A BERENS (PAC)
4441, La Jolla, Nob Hill, Bohemia, Pensacola, Escambia County, Florida, 32504, United States
PENSACOLA, FL 325047839
Phone: (850) 261-8030
Type: Mailing
1717, North E Street, Pensacola, Escambia County, Florida, 32501, United States
SUITE 422
PENSACOLA, FL 325016339
Phone: (850) 444-7050
Fax: (850) 434-8879
Type: Location
PO BOX 95590
SOUTH JORDAN, UT 840950590
Phone: (801) 784-0954
Fax: (801) 352-7976
Type: Mailing
125 BAPTIST WAY STE 4C
PENSACOLA, FL 325032274
Phone: (448) 227-6330
Fax: (850) 626-9606
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $41.
Total Amount is formed as General ($41) + Research ($0) + Ownership ($0) = $41.
Last reported payment date: 2024-10-04 • Largest payer in this snapshot: TELA Bio, Inc. ($41).
Total Amount
$41
General + Research + Ownership
Payments
5
Total payment records
General Amount
$41
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| TELA Bio, Inc. | $41 |
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: 2025-08-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060727000235 | I | Physician Assistant | FL | TBD |
| I20240813001048 | I | Physician Assistant | NH | TBD |
| I20250829004681 | I | Physician Assistant | CO | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99238 | Hospital discharge day management, 30 minutes or less | 12 | 12 | $0 |
Insurance plans in this area (ZIP 32504)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | FL | |
| - | FL | |
| - | FL | |
| Nurse Practitioner | FL | |
| O T O L A R Y N G O L O G Y | UT | |
| - | FL | |
| - | FL | |
| N E U R O S U R G E R Y | FL | |
| - | FL | |
| - | WA |
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