ANNETTE MARIE BOTHUN (PA-C) – Physician Assistant, NPI 1528583846

ANNETTE MARIE BOTHUN (PA-C) is a healthcare provider. based in Warroad, Minnesota. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PAC0723 (ND). The NPI Number for ANNETTE MARIE BOTHUN (PA-C) is 1528583846

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
ANNETTE MARIE BOTHUN (PA-C)
NPI
1528583846
Phone
(218) 386-2020
Address
412 Main Ave NE
Enumeration Date
8 August 2017
Last Update Date
2 June 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2017 (9 years ago)
PAC ID
2567737109
Group Practice PAC ID
6800875345
Professional Enrollment ID
I20180822000528
Address ID
ND582013434Gr1451XEXXX500
Data current as of
10 June 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness85
Years active:8State licenses:2Digital endpointsOther names

4,032 PHYSICIAN ASSISTANT in MN

Provider Addresses for ANNETTE MARIE BOTHUN (PA-C)

  • 412 Main Ave NE

    Warroad, MN 567632342

    Phone: (218) 386-2020

    Type: Location

  • 711 Delmore Dr

    Roseau, MN 567511534

    Phone: (218) 463-1365

    Type: Location

  • 1451 44TH AVE S STE E

    GRAND FORKS, ND 582013434

    Phone: (701) 787-5800

    Fax: (701) 787-5802

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 83 Open Payments records for all available years, with a total value of $2,269.

Total Amount is formed as General ($2,269) + Research ($0) + Ownership ($0) = $2,269.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: US Oncology Corporate, Inc. ($807).

Total Amount

$2,269

General + Research + Ownership

Payments

83

Total payment records

General Amount

$2,269

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2018-08-22

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20171006000836IPhysician AssistantMNTBD
I20180822000528IPhysician AssistantNDTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes271113$0
99213Established patient office or other outpatient visit, 20-29 minutes11671$0
99491Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month7842$0
99490Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month6634$0
99424Principal care management services for a single high-risk disease, first 30 minutes provided personally by qualified health care professional, per calendar month.3129$0
View full utilization report →

Insurance plans in this area (ZIP 56763)

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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: 6800875345View full group profile
NameSpecialtyState
Nurse PractitionerND
Medical Oncology, HematologyND
Radiation Oncology, Medical OncologyND

Reviews

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Frequently asked questions

What is ANNETTE MARIE BOTHUN (PA-C)'s NPI number?
ANNETTE MARIE BOTHUN (PA-C)'s NPI is 1528583846 — the number used across U.S. healthcare to identify this provider.
Would ANNETTE MARIE BOTHUN (PA-C) appear as active to a payer?
You can treat ANNETTE MARIE BOTHUN (PA-C) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for ANNETTE MARIE BOTHUN (PA-C)?
At a glance, ANNETTE MARIE BOTHUN (PA-C) is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
Is ANNETTE MARIE BOTHUN (PA-C) associated with Warroad?
Public fields place ANNETTE MARIE BOTHUN (PA-C) around Warroad, Minnesota. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.