JORI L SHORE – Family Nurse Practitioner, NPI 1013994532
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,031 PHYSICIAN ASSISTANT in MN
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Provider Addresses for JORI L SHORE
Wayzata Boulevard, Blackstone, Saint Louis Park, Hennepin County, Minnesota, 55416, United States
STE 315
ST LOUIS PARK, MN 554261728
Phone: (952) 993-7169
Fax: (952) 993-0300
Type: Mailing
Park Nicollet Clinic, 1885, Plaza Drive, Eagan, Dakota County, Minnesota, 55122, United States
PARK NICOLLET CLINIC - EAGAN
EAGAN, MN 551222612
Phone: (952) 993-4001
Fax: (952) 993-4075
Type: Location
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: 2010-07-28
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100728001213 | I | Physician Assistant | MN | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 99 | 52 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 78 | 53 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 57 | 45 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 39 | 39 | $0 |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 33 | 33 | $0 |
Insurance plans in this area (ZIP 55426)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| Family Practice | MN | |
| - | MN | |
| Pulmonary Disease, Critical Care (Intensivists), Internal Medicine | MN | |
| Cardiac Electrophysiology | MN | |
| Family Practice | MN | |
| Physician Assistant | MN | |
| Physical Therapist In Private Practice | MN | |
| Physician Assistant | MN | |
| D E R M A T O L O G Y | MN |
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