JACINDA ELYSE SIBERIO (MD) – Obstetrics & Gynecology Physician, NPI 1083904049
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
822 OBSTETRICS/GYNECOLOGY in MN
Provider Addresses for JACINDA ELYSE SIBERIO (MD)
9201 WEST BROADWAY AVE
SUITE 601
BROOKLYN PARK, MN 55445
Phone: (763) 587-7900
Fax: (763) 589-7066
Type: Mailing
9825 HOSPITAL DRIVE
SUITE 300
MAPLE GROVE, MN 55369
Phone: (763) 587-7900
Fax: (763) 494-7501
Type: Location
303 E NICOLLET BLVD STE 100
BURNSVILLE, MN 553374588
Phone:
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.
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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: 2015-08-13
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 |
|---|---|---|---|---|
| I20150813010642 | I | Obstetrics/Gynecology | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 12 | 11 | $0 |
Insurance plans in this area (ZIP 55445)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| Colorectal Surgery (Proctology) | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| Family Practice | MN | |
| Internal Medicine, Rheumatology | MN | |
| Family Practice | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| Colorectal Surgery (Proctology) | MN | |
| Internal Medicine, Gastroenterology | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN |
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