Individual provider Active NPI

Kelsey M Golotic, AGACNP

  • Adult Health Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1720853666
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11030613 Issued in FL
Practice address
2780 Cleveland Ave Ste 811
Fort Myers, FL 33901-5817
Phone
(239) 343-3800
Fax
(239) 343-3993
NPI assigned
Nov 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN9446083 FL
Adult Health Nurse Practitioner 363LA2200X APRN11030613 FL Primary

Addresses

Primary practice location

2780 Cleveland Ave Ste 811
Fort Myers, FL 33901-5817

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-3800

Other identifiers 1

IdentifierTypeStateIssuer
121031900MedicaidFL

Other names 1

  • Kelsey M Bereberick Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kberberich392557@Direct.leememorial.org Direct Lee Memorial Health System

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240123002365 FL Practitioner - Nurse Practitioner 8426400623 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

2780 Cleveland Ave
Suite 811
Fort Myers, FL 33901-5817
Phone (239) 343-3800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9446083FLMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Feb 5, 2024 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System Current Accepting new patients
Lee Memorial Health System CurrentSince Feb 5, 2024 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

632 Del Prado Blvd N
Cape Coral, FL 33909
Phone (239) 343-3800

224 Santa Barbara Blvd
Cape Coral, FL 33991
Phone (239) 424-1479

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

2780 Cleveland Ave
Ste 811
Fort Myers, FL 33901
Phone (239) 343-3800

13685 Doctors Way
Ste 350
Fort Myers, FL 33912
Phone (239) 343-1000

2780 Cleveland Ave
Ste 819
Fort Myers, FL 33901
Phone (239) 336-6800

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kberberich392557@direct.leememorial.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1700524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1720853666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-3800",
            "fax_number": "239-343-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 CLEVELAND AVE STE 811",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339015817",
            "telephone_number": "239-343-3800",
            "fax_number": "239-343-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLOTIC",
        "first_name": "KELSEY",
        "middle_name": "M",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-21",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "RN9446083",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11030613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121031900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kberberich392557@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "BEREBERICK",
            "middle_name": "M",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.