MR. RICK LEE NISSEN (M.D.) – Facial Plastic Surgery Physician, NPI 1306842711

MR. RICK LEE NISSEN (M.D.) is a healthcare provider. based in Minneapolis, Minnesota. specializing in OTOLARYNGOLOGY. They hold the professional credentials M.D.. They hold a License No. 30501 (MN). The NPI Number for MR. RICK LEE NISSEN (M.D.) is 1306842711

Main info

Male
Sole Proprietor
45 Years Of Experience
Accepts Medicare Assignment
Name
MR. RICK LEE NISSEN (M.D.)
NPI
1306842711
Phone
(952) 948-9695
Address
8714 LYNDALE AVE S
Enumeration Date
22 June 2005
Last Update Date
25 February 2013

Doctor Profile

Medical School Name
UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Secondary Phone
5072175000
Graduation Year
1981 (45 years ago)
PAC ID
5991895690
Group Practice PAC ID
4587573613
Professional Enrollment ID
I20071219000124
Address ID
MN560731514NE1324XNXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

273 OTOLARYNGOLOGY in MN

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Provider Addresses for MR. RICK LEE NISSEN (M.D.)

  • Lyndale Avenue South, CARAG, Minneapolis, Hennepin County, Minnesota, 55419, United States

    MINNEAPOLIS, MN 554202738

    Phone: (952) 948-9695

    Fax: (952) 948-9086

    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: 2007-12-19

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
I20071219000124IOtolaryngologyMNTBD

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
99203New patient office or other outpatient visit, 30-44 minutes8484$0
99213Established patient office or other outpatient visit, 20-29 minutes8152$0
99204New patient office or other outpatient visit, 45-59 minutes7979$0
69210Removal of impacted ear wax6353$0
99214Established patient office or other outpatient visit, 30-39 minutes5845$0
View full utilization report →

Insurance plans in this area (ZIP 55420)

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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: 4587573613View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for MR. RICK LEE NISSEN (M.D.)?
MR. RICK LEE NISSEN (M.D.) — NPI 1306842711 — is the standard way to identify this listing.
Can I rely on MR. RICK LEE NISSEN (M.D.) being an active provider?
As of the registry snapshot, MR. RICK LEE NISSEN (M.D.) is marked active.
What is MR. RICK LEE NISSEN (M.D.) best known for clinically?
Directory data describes MR. RICK LEE NISSEN (M.D.) with Facial Plastic Surgery Physician. Clinical services aligned with this taxonomy classification.
What address line appears for MR. RICK LEE NISSEN (M.D.)?
MR. RICK LEE NISSEN (M.D.)'s geographic hint is Minneapolis, Minnesota in our summary view.
Is the information about MR. RICK LEE NISSEN (M.D.) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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