KATIE MARIE PETERSON (AGNP) – Nurse Practitioner, NPI 1508265331
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,720 NURSE PRACTITIONER in MN
Provider Addresses for KATIE MARIE PETERSON (AGNP)
2103 DOSWELL AVE
SAINT PAUL, MN 551081731
Phone:
Type: Mailing
8170 33RD AVE S # MS 21110Q
BLOOMINGTON, MN 554254516
Phone:
Type: Mailing
3931 LOUISIANA AVE S
SUITE E202
SAINT LOUIS PARK, MN 554265000
Phone: (952) 993-9184
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: 2014-12-03
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 |
|---|---|---|---|---|
| I20141203000104 | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 21 | 20 | $0 |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 16 | 16 | $0 |
Insurance plans in this area (ZIP 55108)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| Family Practice | MN | |
| - | MN | |
| Pulmonary Disease, Critical Care (Intensivists), Internal Medicine | MN | |
| Cardiac Electrophysiology | MN | |
| Family Practice | MN | |
| Physician Assistant | MN | |
| Physical Therapist In Private Practice | MN | |
| Physician Assistant | MN | |
| D E R M A T O L O G Y | MN |
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