DR. KEITH WAYNE FRIDEL PHD
NPI 1215345244
Psychologist in Shakopee, MN
About Dr. Keith Wayne Fridel Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KEITH WAYNE FRIDEL PHD (NPI 1215345244) is an individual psychologist in Shakopee, Minnesota, licensed in Illinois (071008852) and active in the NPI registry since July 2014. He is enrolled in Medicare PECOS, maintains a secondary practice location in Orland Park, and is a graduate of Other (2011).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Keith Wayne Fridel Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Keith Fridel reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
St Louis Park, MN 55416
- Reassigned Medicare billing, Minnesota enrollment
- Medicare enrollment name: Park Nicollet Clinic
- 2,527 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Keith Fridel's NPI number?
The NPI number for Keith Fridel is 1215345244. It was assigned to this individual provider in the NPPES registry on July 22, 2014.
Where is Keith Fridel located?
Keith Fridel practices at 1415 Saint Francis Ave, Shakopee, MN 55379. The listed phone number is (952) 993-7750.
What is Keith Fridel's specialty?
The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.
Is Keith Fridel enrolled in Medicare?
Yes. Keith Fridel is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Keith Fridel's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Keith Fridel reassigns Medicare benefits to Park Nicollet Methodist Hospital (St Louis Park, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Keith Fridel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Keith Fridel was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.