NATHAN DANIEL PETERSON (PA-C) – Physician Assistant, NPI 1518622703
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,032 PHYSICIAN ASSISTANT in MN
Provider Addresses for NATHAN DANIEL PETERSON (PA-C)
5565 BLAINE AVE STE 225
INVER GROVE HEIGHTS, MN 550761239
Phone: (651) 888-7800
Fax: (651) 888-7801
Type: Mailing
710 COMMERCE DR STE 200
WOODBURY, MN 551254925
Phone:
Type: Mailing
2090 WOODWINDS DR
WOODBURY, MN 551252522
Phone: (651) 968-5201
Fax: (651) 968-5903
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: 2021-12-11
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 |
|---|---|---|---|---|
| I20211211000159 | 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 |
|---|---|---|---|---|
| 95004 | Test for allergy using allergenic extract | 473 | 16 | $0 |
| 69210 | Removal of impacted ear wax | 134 | 120 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 31 | 27 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 55076)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| - | MN | |
| - | MN | |
| Orthopedic Surgery, Sports Medicine | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN |
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