ANDREW N NOTTLESON (MD) – Family Medicine Physician, NPI 1295700854
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,075 FAMILY PRACTICE in MN
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Provider Addresses for ANDREW N NOTTLESON (MD)
2831, Snelling Avenue North, Roseville, Ramsey County, Minnesota, 55113, United States
ROSEVILLE, MN 551131712
Phone: (651) 765-5900
Fax: (651) 765-5901
Type: Location
8170 33RD AVE S # MS 21110Q
MINNEAPOLIS, MN 554254516
Phone: (952) 967-6620
Fax: (651) 765-5901
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: 2005-06-15
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 |
|---|---|---|---|---|
| I20050615000579 | I | Family Practice | 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 |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 285 | 162 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 216 | 141 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 132 | 132 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 116 | 94 | $0 |
| G0008 | Administration of influenza virus vaccine | 39 | 39 | $0 |
Insurance plans in this area (ZIP 55113)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | MN | 90670 | Pneumococcal vaccine for injection into muscle | 24 | 24 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | MN | |
| Occupational Therapist In Private Practice | MN | |
| Qualified Speech Language Pathologist | MN | |
| Physical Therapist In Private Practice | MN | |
| Physical Therapist In Private Practice | MN | |
| Qualified Speech Language Pathologist | MN | |
| Family Practice | MN | |
| Physical Therapist In Private Practice | MN | |
| Physical Therapist In Private Practice | MN | |
| Occupational Therapist In Private Practice | MN |
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