JERI LEAH VERGELDT – Family Medicine Physician, NPI 1215961560

JERI LEAH VERGELDT is a healthcare provider. based in International falls, Minnesota. specializing in FAMILY PRACTICE. They hold a License No. 35532 (MN). The NPI Number for JERI LEAH VERGELDT is 1215961560

Main info

Female
35 Years Of Experience
Accepts Medicare Assignment
Name
JERI LEAH VERGELDT
NPI
1215961560
Phone
(218) 283-9431
Address
2501 KEENAN DR
Enumeration Date
11 July 2006
Last Update Date
9 May 2011

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
2182839431
Graduation Year
1991 (35 years ago)
PAC ID
3375696412
Group Practice PAC ID
7810149002
Professional Enrollment ID
I20090806000407
Address ID
MN566492181IN2501XDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

3,076 FAMILY PRACTICE in MN

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Provider Addresses for JERI LEAH VERGELDT

  • 2501, Keenan Drive, International Falls, Koochiching County, Minnesota, 56649, United States

    INTERNATIONAL FALLS, MN 566492181

    Phone: (218) 283-9431

    Fax: (218) 285-6275

    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: 2009-08-06

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
I20090806000407IFamily 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 56649)

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Provider's Procedures

JERI LEAH VERGELDT performs procedures in FAMILY PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEMN20610Aspiration and/or injection of large joint or joint capsule2416
FAMILY MEDICINEMN90670Pneumococcal vaccine for injection into muscle1919
FAMILY MEDICINEMN93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report2322

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: 7810149002View full group profile
NameSpecialtyState
-MN
Family PracticeMN
Family Practice, Emergency MedicineMN
-MN
General SurgeryMN
Family PracticeMN
Family PracticeMN
Nurse PractitionerMN
Nurse PractitionerMN
Nurse PractitionerMN

Reviews

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Frequently asked questions

How is JERI LEAH VERGELDT identified in CMS data?
CMS-hosted NPPES data lists JERI LEAH VERGELDT with NPI 1215961560.
Can I rely on JERI LEAH VERGELDT being an active provider?
As of the registry snapshot, JERI LEAH VERGELDT is marked active.
What is JERI LEAH VERGELDT's specialty?
The listing groups JERI LEAH VERGELDT with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is JERI LEAH VERGELDT based?
JERI LEAH VERGELDT is tied to International Falls, Minnesota in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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