NICOLE J CHARLES (PAC) – Medical Physician Assistant, NPI 1104008093
Medical 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 J CHARLES (PAC)
500 S MAPLE ST
WACONIA, MN 553871752
Phone: (952) 442-2191
Fax: (952) 974-3201
Type: Location
4729, County Road 101, Minnetonka, Hennepin County, Minnesota, 55345, United States
MINNETONKA, MN 553452634
Phone: (952) 974-3200
Fax: (952) 974-3201
Type: Location
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: 2008-01-19
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 |
|---|---|---|---|---|
| I20080119000009 | 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 |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 140 | 73 | $0 |
| 99239 | Hospital discharge day management, more than 30 minutes | 73 | 70 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 70 | 44 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 25 | 25 | $0 |
Insurance plans in this area (ZIP 55387)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | MN | |
| Internal Medicine | MN | |
| Family Practice | MN | |
| - | MN | |
| - | MN | |
| Physician Assistant | MN | |
| Diagnostic Radiology | MN | |
| Marriage And Family Therapist | MN | |
| Nurse Practitioner | MN | |
| Diagnostic Radiology | MN |
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