KALIE R DRAZENOVICH (CNP) – Family Nurse Practitioner, NPI 1063010304

KALIE R DRAZENOVICH (CNP) is a healthcare provider. based in Grand rapids, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials CNP. They hold a License No. 7673 (MN). The NPI Number for KALIE R DRAZENOVICH (CNP) is 1063010304

Main info

Female
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
KALIE R DRAZENOVICH (CNP)
NPI
1063010304
Phone
(218) 326-3401
Address
1601 GOLF COURSE RD
Enumeration Date
9 October 2020
Last Update Date
30 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2183263401
Graduation Year
2020 (6 years ago)
PAC ID
5092124685
Group Practice PAC ID
8123939550
Professional Enrollment ID
I20210512000428
Address ID
MN557448648GR1601XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for KALIE R DRAZENOVICH (CNP)

  • 1601 GOLF COURSE RD

    GRAND RAPIDS, MN 557448648

    Phone: (218) 326-3401

    Type: Mailing

  • 11452 BROOK RD NW

    ELK RIVER, MN 553308739

    Phone: (612) 244-5325

    Type: Mailing

  • 6300 WEDGWOOD RD N

    MAPLE GROVE, MN 553113647

    Phone: (612) 244-5325

    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: 2021-05-12

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
I20210512000428INurse 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
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes6742$0
99350Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes6737$0
99348Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes4725$0
99347Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes3422$0
99213Established patient office or other outpatient visit, 20-29 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 55744)

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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: 8123939550View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MN
Nurse PractitionerMN
-MN
General SurgeryMN
Family PracticeMN
Nurse PractitionerMN
-MN
Family PracticeMN
Diagnostic RadiologyMN
Cardiovascular Disease (Cardiology), Critical Care (Intensivists), Internal MedicineMN

Reviews

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Frequently asked questions

How do payers reference KALIE R DRAZENOVICH (CNP)?
For KALIE R DRAZENOVICH (CNP), use NPI 1063010304 as the unique 10-digit identifier.
Is KALIE R DRAZENOVICH (CNP) shown as active in public data?
Registry records indicate KALIE R DRAZENOVICH (CNP) maintains an active NPI.
What clinical focus is listed for KALIE R DRAZENOVICH (CNP)?
At a glance, KALIE R DRAZENOVICH (CNP) is tied to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Minnesota is KALIE R DRAZENOVICH (CNP) registered?
Use Grand Rapids, Minnesota as the headline location for KALIE R DRAZENOVICH (CNP) here.
When was this NPI issued?
Enumeration for KALIE R DRAZENOVICH (CNP) is noted as October 9, 2020 where the registry provides it.

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