SHELLY A..J. NEIMAN (CNP) – Family Nurse Practitioner, NPI 1396159976
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,720 NURSE PRACTITIONER in MN
Provider Addresses for SHELLY A..J. NEIMAN (CNP)
1107 HART BLVD
MONTICELLO, MN 553628538
Phone: (763) 271-1370
Type: Location
7063 100TH AVE SE
CLEAR LAKE, MN 553199607
Phone: (218) 839-6655
Type: Mailing
1702 UNIVERSITY DR S
FARGO, ND 581034940
Phone: (701) 364-8000
Type: Mailing
24087 CUYUNA ST
DEERWOOD, MN 564443301
Phone: (188) 335-1602
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: 2014-12-02
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 |
|---|---|---|---|---|
| I20141202000410 | I | Nurse Practitioner | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55362)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| Nurse Practitioner | MN | |
| Certified Registered Nurse Anesthetist (Crna) | ND | |
| Nurse Practitioner | MN | |
| Emergency Medicine | MN | |
| Nurse Practitioner | MN | |
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| Diagnostic Radiology | MN | |
| Nurse Practitioner | MN | |
| Hospitalist, Internal Medicine, Internal Medicine, Hospitalist | WI |
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