SCOTT J RYSDAHL (MD) – Family Medicine Physician, NPI 1114038411

SCOTT J RYSDAHL (MD) is a healthcare provider. based in Minneapolis, Minnesota. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 28806 (MN). The NPI Number for SCOTT J RYSDAHL (MD) is 1114038411

Main info

Male
43 Years Of Experience
Accepts Medicare Assignment
Name
SCOTT J RYSDAHL (MD)
NPI
1114038411
Phone
(612) 262-5000
Address
2925 CHICAGO AVE
Enumeration Date
31 August 2006
Last Update Date
20 January 2023

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
3202433767
Graduation Year
1983 (43 years ago)
PAC ID
9335136985
Group Practice PAC ID
1153555719
Professional Enrollment ID
I20040427000807
Address ID
MN563621445PA200XXSTXX400

Contacts

Secure Messaging
srysdahl94044@excellian.direct.allina.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

3,075 FAMILY PRACTICE in MN

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Provider Addresses for SCOTT J RYSDAHL (MD)

  • Chicago Av, Washington Avenue South, Minneapolis, Hennepin County, Minnesota, 55415:55454, United States

    MINNEAPOLIS, MN 554071321

    Phone: (612) 262-5000

    Type: Mailing

  • 1217, 8th North Street, New Ulm, Brown County, Minnesota, 56073, United States

    NEW ULM, MN 560731552

    Phone: (507) 217-5000

    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: 2004-04-27

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
I20040427000807IFamily PracticeMNTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes508242$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit108108$0
99213Established patient office or other outpatient visit, 20-29 minutes4943$0
17000Destruction of precancer skin growth, 1 growth1615$0
View full utilization report →

Insurance plans in this area (ZIP 55407)

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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: 1153555719View full group profile
NameSpecialtyState
Internal Medicine, HospitalistMN
Family PracticeMN
Nurse PractitionerMN
Cardiovascular Disease (Cardiology), Internal MedicineMN
Family PracticeMN
Internal Medicine, HospitalistMN
Internal Medicine, HospitalistMN
Pediatric Medicine, GastroenterologyMO
Family PracticeMN
-MN

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I verify SCOTT J RYSDAHL (MD) with an NPI only?
You can start verification with NPI 1114038411 for SCOTT J RYSDAHL (MD), then check state licensing separately.
Does the file indicate SCOTT J RYSDAHL (MD) is practicing under active NPI?
Directory data currently reports SCOTT J RYSDAHL (MD) as active.
What is SCOTT J RYSDAHL (MD)'s specialty?
The listing groups SCOTT J RYSDAHL (MD) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where should I expect SCOTT J RYSDAHL (MD) on a map?
Expect Minneapolis, Minnesota as a primary anchor for SCOTT J RYSDAHL (MD) unless the record lists multiple sites.
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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