ROSALYNN VERTIZ-HACKETT (PA) – Physician Assistant, NPI 1053411157
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,032 PHYSICIAN ASSISTANT in MN
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Provider Addresses for ROSALYNN VERTIZ-HACKETT (PA)
8170 33RD AVE S- PO BOX 1309
MAIL STOP 21110Q
MINNEAPOLIS, MN 554254516
Phone: (651) 653-2100
Fax: (651) 653-2125
Type: Mailing
North Highway 61, White Bear Lake, Ramsey County, Minnesota, 55110, United States
WHITE BEAR LAKE, MN 551103653
Phone: (651) 653-2100
Fax: (651) 653-2125
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: 2014-01-09
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 |
|---|---|---|---|---|
| I20140109001150 | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 64 | 48 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 53 | 36 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 50 | 47 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 24 | 24 | $0 |
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 15 | 13 | $0 |
Insurance plans in this area (ZIP 55425)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| Clinical Psychologist | MN | |
| - | MN | |
| P S Y C H I A T R Y | MN | |
| Family Practice | MN | |
| - | MN | |
| - | MN | |
| P O D I A T R Y | MN | |
| Physician Assistant | MN | |
| Physician Assistant | MN |
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