TODD JERAMIE HOLTER (PAC) – Physician Assistant, NPI 1396742896
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,031 PHYSICIAN ASSISTANT in MN
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Provider Addresses for TODD JERAMIE HOLTER (PAC)
5803, Neal Avenue North, Oak Park Heights, Washington County, Minnesota, 55082, United States
OAK PARK HEIGHTS, MN 550822177
Phone: (651) 439-8807
Fax: (651) 439-0232
Type: Mailing
5803 Neal Ave N
Oak Park Heights, MN 550822177
Phone: (651) 439-8807
Fax: (651) 439-0232
Type: Location
8170 33RD AVE S # MS 21110Q
BLOOMINGTON, MN 554254516
Phone:
Type: Mailing
155 RADIO DR
WOODBURY, MN 551252619
Phone: (952) 831-8742
Fax: (952) 977-3459
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $22.
Total Amount is formed as General ($22) + Research ($0) + Ownership ($0) = $22.
Last reported payment date: 2023-09-11 • Largest payer in this snapshot: DePuy Synthes Sales Inc. ($22).
Total Amount
$22
General + Research + Ownership
Payments
1
Total payment records
General Amount
$22
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| DePuy Synthes Sales Inc. | $22 |
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: 2005-02-21
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 |
|---|---|---|---|---|
| I20040129000815 | I | Physician Assistant | WI | TBD |
| I20050221000060 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| 27447 | Replacement of knee joint, both sides of knee | 15 | 15 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 15 | 14 | $0 |
Insurance plans in this area (ZIP 55082)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | MN | 63048 | Partial removal of spine bone with release of spinal cord and/or nerves | 15 | 13 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | MN | |
| - | MN | |
| Physical Medicine And Rehabilitation | MN | |
| Orthopedic Surgery | MN | |
| Occupational Therapist In Private Practice | MN | |
| - | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN | |
| - | MN | |
| - | MN |
Reviews
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