MR. KEITH HOWARD MANTEL (LICSW) – Clinical Social Worker, NPI 1356351118

MR. KEITH HOWARD MANTEL (LICSW) is a healthcare provider. based in South boston, Massachusetts. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 117738 (MA). The NPI Number for MR. KEITH HOWARD MANTEL (LICSW) is 1356351118

Main info

Male
26 Years Of Experience
Accepts Medicare Assignment
Name
MR. KEITH HOWARD MANTEL (LICSW)
NPI
1356351118
Phone
(617) 269-7500
Address
409 W BROADWAY
Enumeration Date
8 August 2006
Last Update Date
6 November 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7815510999
Graduation Year
2000 (26 years ago)
PAC ID
9638171846
Group Practice PAC ID
5991763823
Professional Enrollment ID
I20190605000645
Address ID
MA017573585MI25XXXSTXX300
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

4,194 CLINICAL SOCIAL WORKER in MA

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Provider Addresses for MR. KEITH HOWARD MANTEL (LICSW)

  • 409, West Broadway, Dorchester Heights, South Boston, Boston, Suffolk County, Massachusetts, 02127, United States

    SOUTH BOSTON, MA 021272245

    Phone: (617) 269-7500

    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: 2019-06-05

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
I20190605000645IClinical Social WorkerMATBD

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 02127)

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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: 5991763823View full group profile

Reviews

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Frequently asked questions

What federal number belongs to MR. KEITH HOWARD MANTEL (LICSW)?
The federal identifier for MR. KEITH HOWARD MANTEL (LICSW) is NPI 1356351118.
Is MR. KEITH HOWARD MANTEL (LICSW)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does MR. KEITH HOWARD MANTEL (LICSW) list a primary specialty?
If you are matching referrals, note Clinical Social Worker for MR. KEITH HOWARD MANTEL (LICSW). Clinical services aligned with this taxonomy classification.
What location metadata exists for MR. KEITH HOWARD MANTEL (LICSW)?
The page summarizes South Boston, Massachusetts for MR. KEITH HOWARD MANTEL (LICSW); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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