KEITH KMIECZAK (MSPT) – Physical Therapist, NPI 1932181542
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,280 PHYSICAL THERAPIST IN PRIVATE PRACTICE in PA
Provider Addresses for KEITH KMIECZAK (MSPT)
204 EAGLE VALLEY MALL
EAST STROUDSBURG, PA 183011315
Phone: (570) 424-1706
Fax: (570) 424-6711
Type: Location
Canadensis, Barrett Township, Monroe County, Pennsylvania, 18325, United States
BOX 253
CANADENSIS, PA 18325
Phone:
Type: Mailing
136 LAKE ST
SUITE E
EPHRATA, PA 17522
Phone: (717) 466-5880
Type: Location
297 ORCHARD VIEW DR
LEOLA, PA 175401632
Phone: (717) 283-6797
Type: Mailing
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: 2023-11-23
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 |
|---|---|---|---|---|
| I20231123000072 | I | Physical Therapist In Private Practice | PA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 18301)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OK | |
| - | AL | |
| Physical Therapist In Private Practice | AL | |
| Physical Therapist In Private Practice | NV | |
| - | FL | |
| - | DE | |
| Physical Therapist In Private Practice | PA | |
| Physical Therapist In Private Practice | PA | |
| - | PA | |
| - | PA |
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