Dr Keith Wayne Fridel, PHD - Medicare Psychologist in Shakopee, MN

Dr Keith Wayne Fridel, PHD is a medicare enrolled "Psychologist" provider in Shakopee, Minnesota. He graduated from medical school in 2011 and has 13 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice Park Nicollet Clinic and his current practice location is 1415 Saint Francis Ave, Shakopee, Minnesota. You can reach out to his office (for appointments etc.) via phone at (952) 993-7750.

Dr Keith Wayne Fridel is licensed to practice in Illinois (license number 071008852) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1215345244.

Contact Information

Dr Keith Wayne Fridel, PHD
1415 Saint Francis Ave,
Shakopee, MN 55379-3374
(952) 993-7750
Not Available



Healthcare Provider's Profile

Full NameDr Keith Wayne Fridel
GenderMale
SpecialityClinical Psychologist
Experience13 Years
Location1415 Saint Francis Ave, Shakopee, Minnesota
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Keith Wayne Fridel graduated from medical school in 2011
  NPI Data:
  • NPI Number: 1215345244
  • Provider Enumeration Date: 07/22/2014
  • Last Update Date: 03/17/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 2466498431
  • Enrollment ID: I20170923000058

Medical Identifiers

Medical identifiers for Dr Keith Wayne Fridel such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1215345244NPI-NPPES
071008852OtherILSTATE LICENSE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist 071008852 (Illinois)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Park Nicollet Methodist HospitalSaint louis park, MNHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Park Nicollet Clinic79118194381529

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Keith Wayne Fridel allows following entities to bill medicare on his behalf.
Entity NamePark Nicollet Clinic
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780621904
PECOS PAC ID: 7911819438
Enrollment ID: O20031104000046

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Keith Wayne Fridel is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Keith Wayne Fridel, PHD
8170 33rd Ave S # Ms 21110q,
Bloomington, MN 55425-4516

Ph: () -
Dr Keith Wayne Fridel, PHD
1415 Saint Francis Ave,
Shakopee, MN 55379-3374

Ph: (952) 993-7750

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Psychologist in Shakopee, MN

Linda Louise Miller, MA LP
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 327 S Marschall Rd, Suite 250, Shakopee, MN 55379
Phone: 651-769-6500    Fax: 651-769-6549
Deborah A Battles, MA, LP
Psychologist
Medicare: Medicare Enrolled
Practice Location: 200 4th Ave W, Government Center Rm 300, Shakopee, MN 55379
Phone: 952-496-8396    
Sally Phillips,
Psychologist
Medicare: Accepting Medicare Assignments
Practice Location: 327 Marschall Rd, Suite 250, Shakopee, MN 55379
Phone: 651-769-6500    Fax: 651-769-6549
Ms. Kimberly Ann Christensen, MA, LP
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 200 4th Ave W, Shakopee, MN 55379
Phone: 952-496-8565    Fax: 952-496-8355
Anisa Sophia Mohammed, PSYD, LP
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 200 4th Ave W, #300, Shakopee, MN 55379
Phone: 952-496-8614    
Dr. Devona Garcia-lord, PSY.D., LP
Psychologist
Medicare: Accepting Medicare Assignments
Practice Location: 200 4th Ave W, Shakopee, MN 55379
Phone: 952-496-8481    

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