DR. KEITH WAYNE FRIDEL PHD
NPI 1215345244
Psychologist in Shakopee, MN

Active since July 22, 2014PECOS EnrolledAccepts Medicare Assignment
1415 SAINT FRANCIS AVE, SHAKOPEE, MN 55379(952) 993-7750 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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

NPI1215345244
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. KEITH WAYNE FRIDELCredential: PHD
Location Address1415 SAINT FRANCIS AVEShakopee, MN 55379-3374
Mailing Address8170 33rd Ave S # Ms 21110qBloomington, MN 55425-4516
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateJuly 22, 2014
Last NPPES UpdateMarch 17, 2018
NPI 1215345244 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in IL · 071008852
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1415 SAINT FRANCIS AVE, Shakopee, MN 55379

Secondary Practice Location 1

Location 110640 165th StOrland Park, IL 60467-8734 · Phone (708) 364-0261 · Fax (708) 364-0269

Other Identifiers 1

Other071008852IL · State License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

PECOS PAC ID2466498431
PECOS Enrollment IDI20170923000058
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
46 services46 patients
Psychotherapy, 30 minutes 90832
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 30-minute session, the therapist helps you explore feelings, thoughts, and behaviors to better understand yourself and manage life's challenges.
43 services39 patients

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.

Family Medicine
1415 SAINT FRANCIS AVE
SHAKOPEE, MN 55379
Obstetrics & Gynecology
1415 SAINT FRANCIS AVE
SHAKOPEE, MN 55379
Family Medicine
1415 SAINT FRANCIS AVE
SHAKOPEE, MN 55379
Family Medicine
1415 SAINT FRANCIS AVE
SHAKOPEE, MN 55379
Pediatrics
1415 SAINT FRANCIS AVE
SHAKOPEE, MN 55379
Pharmacist
1415 SAINT FRANCIS AVE
SHAKOPEE, MN 55379
Obstetrics & Gynecology
1415 SAINT FRANCIS AVE, SUITE 200
SHAKOPEE, MN 55379
Physician Assistant
1415 SAINT FRANCIS AVE
SHAKOPEE, MN 55379

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.

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.