MARISSA DRAKE (CNP) – Family Nurse Practitioner, NPI 1124438734
Family Nurse Practitioner
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Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MARISSA DRAKE (CNP)
4720 GRAND AVE S
APT 2
MINNEAPOLIS, MN 554195430
Phone: (612) 306-4002
Type: Mailing
3809 42ND AVE S
MINNEAPOLIS, MN 554063503
Phone: (612) 273-3000
Type: Location
307 1ST AVE NE
MINNEAPOLIS, MN 554132205
Phone: (612) 284-8206
Fax: (612) 284-8202
Type: Mailing
2004 FORD PKWY
SAINT PAUL, MN 551161931
Phone: (612) 256-8225
Fax: (612) 457-0216
Type: Mailing
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: 2014-09-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-09-30 (982 days ago).
Enrollment records
1
Earliest due date
2023-09-30
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 |
|---|---|---|---|---|
| I20140929002391 | I | Nurse Practitioner | MN | 2023-09-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 18 | 11 | $0 |
Insurance plans in this area (ZIP 55419)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | MN | 83036 | Hemoglobin A1C level | 13 | 13 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| - | MN | |
| - | MN | |
| Family Practice | MN | |
| Family Practice | IL | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN |
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