JUSTINE FOSLE (FNP-C) – Nurse Practitioner, NPI 1104661818

JUSTINE FOSLE (FNP-C) is a healthcare provider. based in Minneapolis, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 11803 (MN). The NPI Number for JUSTINE FOSLE (FNP-C) is 1104661818

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
JUSTINE FOSLE (FNP-C)
NPI
1104661818
Phone
Not provided
Address
5115 EXCELSIOR BLVD STE 712
Enumeration Date
26 June 2024
Last Update Date
23 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9145895503
Graduation Year
2024 (2 years ago)
PAC ID
6507306446
Group Practice PAC ID
0042624306
Professional Enrollment ID
I20240906001313
Address ID
MN55416XXXXSTXXXXXXXXXX00
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness75
Years active:1State licenses:2Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for JUSTINE FOSLE (FNP-C)

  • 5115 EXCELSIOR BLVD STE 712

    MINNEAPOLIS, MN 554162906

    Phone:

    Type: Mailing

  • 2820 INGLEWOOD AVE S

    ST LOUIS PARK, MN 554164112

    Phone: (914) 589-5503

    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: 2024-09-06

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
I20240906001313INurse 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 55416)

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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: 0042624306View full group profile
NameSpecialtyState
Family PracticeMN
Nurse PractitionerMN
Nurse PractitionerMN
Family PracticeMN
Nurse PractitionerMN
Internal MedicineMN
Nurse PractitionerMN
Physician AssistantMN
Certified Clinical Nurse Specialist (Cns)MN
Nurse PractitionerMN

Reviews

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Frequently asked questions

Can I verify JUSTINE FOSLE (FNP-C) with an NPI only?
You can start verification with NPI 1104661818 for JUSTINE FOSLE (FNP-C), then check state licensing separately.
Is JUSTINE FOSLE (FNP-C) listed as active for patients and plans?
The listing shows JUSTINE FOSLE (FNP-C) as active in the NPI system.
What is JUSTINE FOSLE (FNP-C)'s primary classification?
Nurse Practitioner is the headline specialty for JUSTINE FOSLE (FNP-C) here. Clinical services aligned with this taxonomy classification.
Does JUSTINE FOSLE (FNP-C) list a practice location?
Patients near Minneapolis, Minnesota may find JUSTINE FOSLE (FNP-C) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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