BROOKE ELIZABETH PETTINELLI (NP) – Family Nurse Practitioner, NPI 1093023772

BROOKE ELIZABETH PETTINELLI (NP) is a healthcare provider. based in Virginia, Minnesota. specializing in Family Nurse Practitioner. They hold the professional credentials NP. They hold a License No. R179144-4 (MN). The NPI Number for BROOKE ELIZABETH PETTINELLI (NP) is 1093023772

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
BROOKE ELIZABETH PETTINELLI (NP)
NPI
1093023772
Phone
(218) 741-0150
Address
1101 9TH ST N
Enumeration Date
16 September 2010
Last Update Date
19 September 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2187410150
Graduation Year
2010 (16 years ago)
PAC ID
3375723026
Group Practice PAC ID
2567374283
Professional Enrollment ID
I20110211000754
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:15State licenses:1Digital endpointsOther names

Provider Addresses for BROOKE ELIZABETH PETTINELLI (NP)

  • 1101 9TH ST N

    DULUTH CLINIC-VIRGINIA

    VIRGINIA, MN 557922329

    Phone: (218) 741-0150

    Mailing address matches the actual address.

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: 2011-02-11

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
I20110211000754INurse 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
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes10939$0
99239Hospital discharge day management, more than 30 minutes2828$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes1313$0
View full utilization report →

Insurance plans in this area (ZIP 55792)

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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: 2567374283View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMT
-ND
Physician AssistantMN
Nurse PractitionerSD
-MN
Qualified AudiologistMN
-MN
-MN
P A T H O L O G YWV
Family PracticeMN

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Frequently asked questions

How do I look up BROOKE ELIZABETH PETTINELLI (NP) by NPI?
Use NPI 1093023772 when you need to reference BROOKE ELIZABETH PETTINELLI (NP) in forms, claims, or directories.
Is BROOKE ELIZABETH PETTINELLI (NP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is BROOKE ELIZABETH PETTINELLI (NP)?
The page reflects Family Nurse Practitioner for BROOKE ELIZABETH PETTINELLI (NP). Clinical services aligned with this taxonomy classification.
What location shows for BROOKE ELIZABETH PETTINELLI (NP)?
We surface Virginia, Minnesota for BROOKE ELIZABETH PETTINELLI (NP) based on available NPPES addresses.
How can I contact BROOKE ELIZABETH PETTINELLI (NP)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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