KELLY GENDALL (MD) – General Practice Physician, NPI 1942418579
General Practice Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
12,425 INTERNAL MEDICINE in FL
Provider Addresses for KELLY GENDALL (MD)
255 12TH ST
ATLANTIC BEACH, FL 322335707
Phone:
Type: Mailing
410 ATLANTIC BLVD
NEPTUNE BEACH, FL 322664022
Phone: (610) 217-2625
Type: Location
Box, Blayds Yard, Holbeck Urban Village, Leeds, West Yorkshire, Yorkshire and the Humber, England, LS1 4AF, United Kingdom
RICHMOND, VA 232980257
Phone: (804) 828-9783
Type: Mailing
VCU Medical Center, 1250, East Marshall Street, Shockoe Slip, Richmond, Richmond City, Virginia, 23219, United States
RICHMOND, VA 232985051
Phone: (804) 828-9783
Type: Location
6520 FORT CAROLINE RD
JACKSONVILLE, FL 322772044
Phone: (904) 745-3618
Fax: (904) 722-4271
Type: Mailing
1215 DUNN AVE STE 1
JACKSONVILLE, FL 322184897
Phone: (904) 696-7474
Fax: (904) 696-7476
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 12 Open Payments records for all available years, with a total value of $216.
Total Amount is formed as General ($216) + Research ($0) + Ownership ($0) = $216.
Last reported payment date: 2024-07-02 • Largest payer in this snapshot: Lilly USA, LLC ($69).
Total Amount
$216
General + Research + Ownership
Payments
12
Total payment records
General Amount
$216
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-02
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2021-09-29
PECOS data refreshed: 2026-06-15
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210929002584 | I | Internal Medicine | FL | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 58 | 52 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 14 | 13 | $0 |
Insurance plans in this area (ZIP 32233)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| Physician Assistant | WA | |
| - | FL | |
| Internal Medicine | FL | |
| - | PA | |
| - | FL | |
| - | FL | |
| Physician Assistant | FL | |
| - | FL | |
| - | FL |
Reviews
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