KEITH FENDELANDER – Addiction (Substance Use Disorder) Counselor, NPI 1578982369

KEITH FENDELANDER is a healthcare provider. based in Punta gorda, Florida. specializing in MENTAL HEALTH COUNSELOR. The NPI Number for KEITH FENDELANDER is 1578982369

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
KEITH FENDELANDER
NPI
1578982369
Phone
(941) 639-8300
Address
1700 EDUCATION AVE
Enumeration Date
9 April 2014
Last Update Date
9 April 2014

Doctor Profile

Medical School Name
FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
9416398300
Graduation Year
2005 (21 years ago)
PAC ID
1557809985
Group Practice PAC ID
4587649918
Professional Enrollment ID
I20240816002333
Address ID
FL339506222PU1700XAVEX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience29
Completeness75
Years active:12State licenses:0Digital endpointsOther names

3,020 MENTAL HEALTH COUNSELOR in FL

Provider Addresses for KEITH FENDELANDER

  • 1700 EDUCATION AVE

    PUNTA GORDA, FL 339506222

    Phone: (941) 639-8300

    Fax: (941) 347-6455

    Mailing address matches the actual address.

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: 2024-08-16

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
I20240816002333IMental Health CounselorFLTBD

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 33950)

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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: 4587649918View full group profile
NameSpecialtyState
Mental Health CounselorFL
Nurse PractitionerFL
P S Y C H I A T R YFL
Mental Health CounselorNY
Clinical Social WorkerFL
Clinical Social WorkerFL
Nurse PractitionerFL
Clinical Social WorkerFL
-FL
-FL

Reviews

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Frequently asked questions

How do I look up KEITH FENDELANDER by NPI?
Use NPI 1578982369 when you need to reference KEITH FENDELANDER in forms, claims, or directories.
Is KEITH FENDELANDER active in the national directory?
KEITH FENDELANDER's public NPI profile is in an active state.
What kind of provider is KEITH FENDELANDER?
The page reflects Addiction (Substance Use Disorder) Counselor for KEITH FENDELANDER. Clinical services aligned with this taxonomy classification.
Does KEITH FENDELANDER practice in Florida?
You will see Punta Gorda, Florida on file for KEITH FENDELANDER alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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