KATERINA O. BELOUSOVA (PA-C) – Physician Assistant, NPI 1235419326

KATERINA O. BELOUSOVA (PA-C) is a healthcare provider. based in Rogers, Minnesota. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 10920 (MN). The NPI Number for KATERINA O. BELOUSOVA (PA-C) is 1235419326

Main info

Female
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
KATERINA O. BELOUSOVA (PA-C)
NPI
1235419326
Phone
(763) 504-6400
Address
21395 John Milless Dr
Enumeration Date
22 August 2011
Last Update Date
24 August 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7635725700
Graduation Year
2011 (15 years ago)
PAC ID
8224202577
Group Practice PAC ID
7113830142
Professional Enrollment ID
I20111122000705
Address ID
MN554431400BR10000NXXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:14State licenses:1Digital endpointsOther names

4,032 PHYSICIAN ASSISTANT in MN

Provider Addresses for KATERINA O. BELOUSOVA (PA-C)

  • 21395 John Milless Dr

    suite 100

    Rogers, MN 553744402

    Phone: (763) 504-6400

    Fax: (763) 504-6410

    Type: Location

  • 21395 JOHN MILLESS DR

    SUITE 100

    ROGERS, MN 553744402

    Phone: (763) 504-6400

    Fax: (763) 504-6410

    Type: Mailing

  • 10000 ZANE AVE N

    BROOKLYN PARK, MN 554431400

    Phone: (763) 572-5700

    Fax: (763) 596-6200

    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: 2011-11-22

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
I20111122000705IPhysician 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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes3933$0
36415Insertion of needle into vein for collection of blood sample3630$0
99213Established patient office or other outpatient visit, 20-29 minutes3028$0
80048Blood test, basic group of blood chemicals (calcium, total)2119$0
80061Blood test, lipids (cholesterol and triglycerides)1919$0
View full utilization report →

Insurance plans in this area (ZIP 55374)

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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: 7113830142View full group profile

Reviews

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Frequently asked questions

Can I cross-check KATERINA O. BELOUSOVA (PA-C) using NPI 1235419326?
NPI 1235419326 belongs to KATERINA O. BELOUSOVA (PA-C); compare other details if you need extra assurance.
Active or inactive — what applies to KATERINA O. BELOUSOVA (PA-C)?
You should see KATERINA O. BELOUSOVA (PA-C) as active in CMS-hosted NPPES data.
What kind of doctor is KATERINA O. BELOUSOVA (PA-C)?
KATERINA O. BELOUSOVA (PA-C) is associated with Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with KATERINA O. BELOUSOVA (PA-C)?
Directory geography for KATERINA O. BELOUSOVA (PA-C) centers on Rogers, Minnesota.
Can I trust this NPI listing for KATERINA O. BELOUSOVA (PA-C)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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