KRISSA ANN JEFFERIS (RN, CPNP) – Pediatric Nurse Practitioner, NPI 1093052029

KRISSA ANN JEFFERIS (RN, CPNP) is a healthcare provider. based in Saint paul, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials RN, CPNP. They hold a License No. R1738203 (MN). The NPI Number for KRISSA ANN JEFFERIS (RN, CPNP) is 1093052029

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
KRISSA ANN JEFFERIS (RN, CPNP)
NPI
1093052029
Phone
(651) 578-5242
Address
200 UNIVERSITY AVE E
Enumeration Date
10 January 2013
Last Update Date
10 January 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6512912848
Graduation Year
2010 (16 years ago)
PAC ID
5890933279
Group Practice PAC ID
0547169211
Professional Enrollment ID
I20130523000600
Address ID
MN551012507SA200XXEXXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for KRISSA ANN JEFFERIS (RN, CPNP)

  • 200 UNIVERSITY AVE E

    SAINT PAUL, MN 551012507

    Phone: (651) 578-5242

    Fax: (651) 229-3844

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $15.

Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.

Last reported payment date: 2024-06-13 • Largest payer in this snapshot: Smith+Nephew, Inc. ($15).

Total Amount

$15

General + Research + Ownership

Payments

1

Total payment records

General Amount

$15

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-13

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Smith+Nephew, Inc.$15
View all Open Payments →|Open Payments Risk Radar →

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: 2013-05-23

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
I20130523000600INurse 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55101)

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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: 0547169211View full group profile
NameSpecialtyState
-MN
Physician AssistantMN
Orthopedic SurgeryMN
Nurse PractitionerMN
Certified Registered Nurse Anesthetist (Crna)MN
N E U R O L O G YMN
Nurse PractitionerMN
-MN
Physical Medicine And RehabilitationMN
Internal Medicine, Pediatric MedicineMN

Reviews

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Frequently asked questions

Where can patients find KRISSA ANN JEFFERIS (RN, CPNP)'s NPI?
You can confirm KRISSA ANN JEFFERIS (RN, CPNP) with NPI 1093052029; it appears in the national provider directory.
Is KRISSA ANN JEFFERIS (RN, CPNP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is KRISSA ANN JEFFERIS (RN, CPNP)?
The page reflects Pediatric Nurse Practitioner for KRISSA ANN JEFFERIS (RN, CPNP). Clinical services aligned with this taxonomy classification.
Does KRISSA ANN JEFFERIS (RN, CPNP) practice in Minnesota?
You will see Saint Paul, Minnesota on file for KRISSA ANN JEFFERIS (RN, CPNP) alongside any extra practice locations.
Is KRISSA ANN JEFFERIS (RN, CPNP) a real provider?
This page reflects official NPPES data for NPI 1093052029. Always confirm identity and privileges with the practice and licensing boards.

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