MR. MATELAND LESTERY III KEITH (PMHNP-ABC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1457964843

MR. MATELAND LESTERY III KEITH (PMHNP-ABC) is a healthcare provider. based in Avon, Indiana. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP-ABC. They hold a License No. 28243714A (IN). The NPI Number for MR. MATELAND LESTERY III KEITH (PMHNP-ABC) is 1457964843

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
MR. MATELAND LESTERY III KEITH (PMHNP-ABC)
NPI
1457964843
Phone
(317) 514-9139
Address
8309 DENVER DR
Enumeration Date
26 August 2020
Last Update Date
1 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9413672356
Graduation Year
2021 (5 years ago)
PAC ID
3072901529
Professional Enrollment ID
I20211102002403
Address ID
FL342312406SA3231XDRXX404
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:5State licenses:2Digital endpointsOther names

8,192 NURSE PRACTITIONER in IN

Provider Addresses for MR. MATELAND LESTERY III KEITH (PMHNP-ABC)

  • 8309 DENVER DR

    AVON, IN 461230123

    Phone: (317) 514-9139

    Type: Mailing

  • 421 COMMERCIAL CT STE B

    VENICE, FL 342921656

    Phone: (941) 244-4377

    Fax: (941) 445-4186

    Type: Mailing

  • 1990 MAIN ST STE 750

    SARASOTA, FL 342368000

    Phone: (941) 367-2356

    Fax: (941) 200-4201

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 96 Open Payments records for all available years, with a total value of $2,146.

Total Amount is formed as General ($2,146) + Research ($0) + Ownership ($0) = $2,146.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($390).

Total Amount

$2,146

General + Research + Ownership

Payments

96

Total payment records

General Amount

$2,146

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2021-11-02

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
I20211102002403INurse PractitionerFLTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90833Psychotherapy with evaluation and management visit, 30 minutes34896$0
99214Established patient office or other outpatient visit, 30-39 minutes30589$0
90837Psychotherapy, 1 hour10119$0
99204New patient office or other outpatient visit, 45-59 minutes2727$0
View full utilization report →

Insurance plans in this area (ZIP 46123)

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Reviews

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Frequently asked questions

What NPI should I save for MR. MATELAND LESTERY III KEITH (PMHNP-ABC)?
Save NPI 1457964843 if you need a stable reference for MR. MATELAND LESTERY III KEITH (PMHNP-ABC).
Is MR. MATELAND LESTERY III KEITH (PMHNP-ABC)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does MR. MATELAND LESTERY III KEITH (PMHNP-ABC) list a primary specialty?
If you are matching referrals, note Psychiatric/Mental Health Nurse Practitioner for MR. MATELAND LESTERY III KEITH (PMHNP-ABC). Clinical services aligned with this taxonomy classification.
What location shows for MR. MATELAND LESTERY III KEITH (PMHNP-ABC)?
We surface Avon, Indiana for MR. MATELAND LESTERY III KEITH (PMHNP-ABC) based on available NPPES addresses.
What if Avon, Indiana seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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