SADIE ANN IVERSON (ANP) – Adult Health Nurse Practitioner, NPI 1174878763

SADIE ANN IVERSON (ANP) is a healthcare provider. based in Robbinsdale, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials ANP. They hold a License No. R161013-0 (MN). The NPI Number for SADIE ANN IVERSON (ANP) is 1174878763

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
SADIE ANN IVERSON (ANP)
NPI
1174878763
Phone
(763) 581-5678
Address
3300 OAKDALE AVE N
Enumeration Date
19 July 2012
Last Update Date
28 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
80087305611
Graduation Year
2012 (14 years ago)
PAC ID
3173771144
Group Practice PAC ID
6305024373
Professional Enrollment ID
I20120917000418
Address ID
MN553648239MI5520XCVXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:13State licenses:1Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for SADIE ANN IVERSON (ANP)

  • 3300 OAKDALE AVE N

    ROBBINSDALE, MN 554222926

    Phone: (763) 581-5678

    Fax: (763) 581-9341

    Type: Mailing

  • 5320 W 23RD ST

    ST LOUIS PARK, MN 554161663

    Phone: (763) 581-5678

    Fax: (763) 581-9341

    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: 2012-09-17

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
I20120917000418INurse 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes3517$0
99348Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes3221$0
View full utilization report →

Insurance plans in this area (ZIP 55422)

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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: 6305024373View full group profile

Reviews

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Frequently asked questions

Is SADIE ANN IVERSON (ANP) listed with a National Provider Identifier?
Yes — SADIE ANN IVERSON (ANP) has NPI 1174878763 on file in the registry.
Active or inactive — what applies to SADIE ANN IVERSON (ANP)?
You should see SADIE ANN IVERSON (ANP) as active in CMS-hosted NPPES data.
How would a patient describe SADIE ANN IVERSON (ANP)'s focus?
For SADIE ANN IVERSON (ANP), the primary taxonomy reads as Adult Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with SADIE ANN IVERSON (ANP)?
Directory geography for SADIE ANN IVERSON (ANP) centers on Robbinsdale, Minnesota.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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