NICHOLAS JAMES PRUETT (PA-C) – Physician Assistant, NPI 1164737417
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,031 PHYSICIAN ASSISTANT in MN
Provider Addresses for NICHOLAS JAMES PRUETT (PA-C)
1630 101st Ave NE Ste 160
Blaine, MN 554493403
Phone: (952) 345-3000
Fax: (952) 345-6789
Type: Location
4801 W 81ST ST STE 112
BLOOMINGTON, MN 554371111
Phone: (952) 345-3000
Fax: (952) 345-6789
Type: Mailing
11850 BLACKFOOT ST NW
STE 490
COON RAPIDS, MN 554332773
Phone: (651) 968-5201
Type: Mailing
11850 BLACKFOOT ST NW STE 490
COON RAPIDS, MN 554332773
Phone: (763) 427-1137
Type: Location
11850 Blackfoot St NW Ste 490
Coon Rapids, MN 554332773
Phone: (763) 427-1137
Type: Location
162 Cobblestone Ln
Burnsville, MN 553374578
Phone: (952) 345-3000
Fax: (952) 345-6789
Type: Location
15700 37th Ave N Ste 150
Plymouth, MN 554463675
Phone: (651) 968-5201
Type: Location
7650 Currell Blvd Ste 260
Woodbury, MN 551258209
Phone: (952) 345-3000
Fax: (952) 345-6789
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $26.
Total Amount is formed as General ($26) + Research ($0) + Ownership ($0) = $26.
Last reported payment date: 2023-01-09 • Largest payer in this snapshot: Medtronic, Inc. ($26).
Total Amount
$26
General + Research + Ownership
Payments
1
Total payment records
General Amount
$26
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-01-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $26 |
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: 2011-01-03
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110103000761 | I | Physician Assistant | MN | 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 |
|---|---|---|---|---|
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 118 | 69 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 57 | 57 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 42 | 38 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 32 | 29 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 14 | 14 | $0 |
Insurance plans in this area (ZIP 55449)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| Occupational Therapist In Private Practice | MN | |
| - | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN | |
| Qualified Audiologist | MN | |
| Occupational Therapist In Private Practice | MN | |
| Physical Therapist In Private Practice | MN | |
| Occupational Therapist In Private Practice | MN | |
| - | 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.