NICOLE K BEAUVAIS (PA-C, MMS) – Physician Assistant, NPI 1063674109
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,031 PHYSICIAN ASSISTANT in MN
Provider Addresses for NICOLE K BEAUVAIS (PA-C, MMS)
909 FULTON ST SE
MINNEAPOLIS, MN 554554800
Phone: (612) 672-7422
Type: Mailing
909 Fulton St SE
Minneapolis, MN 554554800
Phone: (612) 672-7422
Type: Location
270 MAIN ST N STE 300
STILLWATER, MN 550826788
Phone: (651) 342-1039
Fax: (651) 342-1428
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: 2013-04-17
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 |
|---|---|---|---|---|
| I20130417000704 | 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 |
|---|---|---|---|---|
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 16 | 11 | $0 |
Insurance plans in this area (ZIP 55455)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MN | |
| Nurse Practitioner | MN | |
| - | MN | |
| Nurse Practitioner | MN | |
| Physician Assistant | PA | |
| - | MN | |
| Nurse Practitioner | MN | |
| Physician Assistant | MN | |
| Physician Assistant | MN | |
| - | MN |
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