Edward J Killeen, M.D.

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

License

ME 58216 Issued in FL

Practice address

2789 Ortiz Ave
Fort Myers, FL 33905-7806

Phone

(239) 275-3222

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Center of Revitalizing Psychiatry, P.C.Group PAC ID 0648239988, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Center of Revitalizing Psychiatry, P.C.

  • Psychiatry Physician
  • Rochelle Park, NJ
  • NPI 1356497960

  FL

  Medicare reassignment Care Compare group NPD
• Center of Revitalizing Psychiatry PC

  • Adult Mental Health Clinic/Center
  • Sarasota, FL
  • NPI 1538572854
  NPD (past)
• Gulf Coast Counseling, Inc

  • Clinical Social Worker
  • Englewood, FL
  • NPI 1861602005
  NPD (past)
• Gulf Coast Health Care Services, Inc.

  • Psychiatry Physician
  • Venice, FL
  • NPI 1356355358

  Geriatric Psychiatry

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1376578336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2789 ORTIZ AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057806",
            "telephone_number": "239-275-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2789 ORTIZ AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057806",
            "telephone_number": "239-275-3222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2033 Wood St Ste 220",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342377927",
            "country_code": "US",
            "telephone_number": "941-677-3366",
            "fax_number": "941-677-3367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLEEN",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "FL",
            "license": "ME 58216",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "MA",
            "license": "203612",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anjanet Kiesel, MA, LMHC
• Yolanda Kieser, DMD
• Erica Kilgore
• Iuliana Kiliment, M.D.
• Debra Killackey
• Christine Kilpatrick, PT
• Su Kim-Hummel
• Brian K. Kim, M.D.
• Elizabeth S Kim, CRNA
• Michael Kwangsoo Kim, M.D.

• Geriatric Psychiatry Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Geriatric Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.