KATIE TETZLAFF (PA-C) – Physician Assistant, NPI 1104371897
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,031 PHYSICIAN ASSISTANT in MN
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Provider Addresses for KATIE TETZLAFF (PA-C)
1680, Diagonal Road, Worthington, Nobles County, Minnesota, 56187, United States
WORTHINGTON, MN 561871008
Phone:
Type: Mailing
400 22ND AVE
BROOKINGS, SD 570062450
Phone:
Type: Mailing
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 $23.
Total Amount is formed as General ($23) + Research ($0) + Ownership ($0) = $23.
Last reported payment date: 2024-11-15 • Largest payer in this snapshot: Astellas Pharma US Inc ($23).
Total Amount
$23
General + Research + Ownership
Payments
1
Total payment records
General Amount
$23
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Astellas Pharma US Inc | $23 |
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: 2021-04-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20161123001373 | I | Physician Assistant | MN | TBD |
| I20210421001753 | I | Physician Assistant | SD | 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 |
|---|---|---|---|---|
| 81001 | Manual urinalysis test with examination using microscope, automated | 45 | 44 | $0 |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 43 | 42 | $0 |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 33 | 31 | $0 |
| 71046 | X-ray of chest, 2 views | 32 | 31 | $0 |
| 93005 | Routine electrocardiogram (ecg) using at least 12 leads with tracing | 26 | 26 | $0 |
Insurance plans in this area (ZIP 56187)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| Physician Assistant | SD | |
| - | SD | |
| - | SD | |
| Nurse Practitioner | MN | |
| - | SD | |
| Nurse Practitioner | SD | |
| Nurse Practitioner | SD | |
| Nurse Practitioner | MN | |
| - | MN |
Reviews
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