ALEXIS MILDRED MYHRE (PA-C) – Physician Assistant, NPI 1164112934

ALEXIS MILDRED MYHRE (PA-C) is a healthcare provider. based in Roseville, Minnesota. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 15518 (MN). The NPI Number for ALEXIS MILDRED MYHRE (PA-C) is 1164112934

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
ALEXIS MILDRED MYHRE (PA-C)
NPI
1164112934
Phone
(651) 241-5290
Address
2720 FAIRVIEW AVE N STE 100
Enumeration Date
15 May 2023
Last Update Date
30 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6512415290
Graduation Year
2025 (1 year ago)
PAC ID
5698262855
Group Practice PAC ID
6709771363
Professional Enrollment ID
I20251013003020
Address ID
MN551131306RO2720XNXXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Digital endpointsOther names

4,031 PHYSICIAN ASSISTANT in MN

Provider Addresses for ALEXIS MILDRED MYHRE (PA-C)

  • 2720 FAIRVIEW AVE N STE 100

    ROSEVILLE, MN 551131306

    Phone: (651) 241-5290

    Mailing address matches the actual address.

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: 2025-10-13

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
I20251013003020IPhysician AssistantMNTBD

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 55113)

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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: 6709771363View full group profile
NameSpecialtyState
N E U R O L O G YMN
Clinical PsychologistMN
Physician AssistantMN
-MN
Clinical PsychologistMN
Nurse PractitionerMN
N E U R O L O G YMN
Physician AssistantMN
N E U R O L O G YMN
N E U R O L O G YMN

Reviews

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Frequently asked questions

What identifier follows ALEXIS MILDRED MYHRE (PA-C) across health systems?
The NPI 1164112934 uniquely identifies ALEXIS MILDRED MYHRE (PA-C) in U.S. healthcare data.
Is ALEXIS MILDRED MYHRE (PA-C) currently accepting referrals based on NPI status?
Registry metadata lists ALEXIS MILDRED MYHRE (PA-C) as active.
What type of care does ALEXIS MILDRED MYHRE (PA-C) provide?
ALEXIS MILDRED MYHRE (PA-C)'s profile centers on Physician Assistant. Clinical services aligned with this taxonomy classification.
What city is tied to ALEXIS MILDRED MYHRE (PA-C)?
The directory associates ALEXIS MILDRED MYHRE (PA-C) with Roseville, Minnesota. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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