COURTNEY KIESOW (NP) – Women's Health Nurse Practitioner, NPI 1750759502

COURTNEY KIESOW (NP) is a healthcare provider. based in Somerville, Massachusetts. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. CNP4185 (MN). The NPI Number for COURTNEY KIESOW (NP) is 1750759502

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
COURTNEY KIESOW (NP)
NPI
1750759502
Phone
(608) 332-1670
Address
887 BROADWAY
Enumeration Date
10 September 2015
Last Update Date
22 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6125435555
Graduation Year
2014 (12 years ago)
PAC ID
9830499714
Group Practice PAC ID
7911892849
Professional Enrollment ID
I20151125000576
Address ID
MN554151569MI525XXMCXX501
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:10State licenses:1Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for COURTNEY KIESOW (NP)

  • 887 BROADWAY

    SOMERVILLE, MA 021441903

    Phone: (608) 332-1670

    Type: Mailing

  • 1200 LAGOON AVE

    MINNEAPOLIS, MN 554082077

    Phone: (612) 823-6300

    Type: Location

  • 525 PORTLAND AVE

    MINNEAPOLIS, MN 554151533

    Phone: (612) 596-7005

    Fax: (612) 766-2522

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-11-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20151125000576INurse PractitionerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
36415Insertion of needle into vein for collection of blood sample1111$0
View full utilization report →

Insurance plans in this area (ZIP 02144)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7911892849View full group profile
NameSpecialtyState
Clinical PsychologistMN
Nurse PractitionerMN
Clinical PsychologistMN
Mental Health CounselorMN
Clinical PsychologistMN
Infectious DiseaseMN
Mental Health CounselorMN
-MN
Nurse PractitionerMN
-MN

Reviews

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Frequently asked questions

What NPI should I save for COURTNEY KIESOW (NP)?
Save NPI 1750759502 if you need a stable reference for COURTNEY KIESOW (NP).
Is COURTNEY KIESOW (NP) currently active in the NPI registry?
CMS-published data lists COURTNEY KIESOW (NP) as an active registrant.
What does COURTNEY KIESOW (NP) treat or focus on?
Patients typically see COURTNEY KIESOW (NP) under the specialty Women's Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does COURTNEY KIESOW (NP) practice in Massachusetts?
You will see Somerville, Massachusetts on file for COURTNEY KIESOW (NP) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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