DR. PAUL A KETTLER (M.D.) – Internal Medicine Physician, NPI 1235194598
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
690 HOSPITALIST in MN
Provider Addresses for DR. PAUL A KETTLER (M.D.)
201 E Nicollet Blvd
Burnsville, MN 553375714
Phone: (952) 892-2117
Fax: (952) 892-2268
Type: Location
Fairview Ridges Hospital, 201, East Nicollet Boulevard, Burnsville, Dakota County, Minnesota, 55337, United States
BURNSVILLE, MN 553371321
Phone: (952) 892-2117
Fax: (952) 892-2268
Type: Mailing
559, North Capitol Boulevard, Frogtown, Saint Paul, Ramsey County, Minnesota, 55103, United States
SAINT PAUL, MN 551032101
Phone: (651) 326-2400
Fax: (651) 326-2440
Type: Location
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: 2024-08-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20051228000559 | I | Internal Medicine | MN | TBD |
| I20240821001779 | I | Hospitalist | WI | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55337)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pulmonary Disease | CO | |
| - | MN | |
| - | MN | |
| Family Practice | MN | |
| - | MO | |
| - | MN | |
| - | VA | |
| - | MN | |
| - | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN |
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