DR. JAY L. PETTIS (D.C.) – Chiropractor, NPI 1548215320

DR. JAY L. PETTIS (D.C.) is a healthcare provider. based in Eagan, Minnesota. specializing in CHIROPRACTIC. They hold the professional credentials D.C.. They hold a License No. 4807 (MN). The NPI Number for DR. JAY L. PETTIS (D.C.) is 1548215320

Main info

Male
23 Years Of Experience
Accepts Medicare Assignment
Name
DR. JAY L. PETTIS (D.C.)
NPI
1548215320
Phone
(651) 405-3990
Address
1570 CENTURY POINT
Enumeration Date
23 May 2006
Last Update Date
16 November 2007

Doctor Profile

Medical School Name
NORTHWESTERN COLLEGE OF CHIROPRACTIC
Secondary Phone
6512611923
Graduation Year
2003 (23 years ago)
PAC ID
3678578861
Professional Enrollment ID
I20060921000394
Address ID
MN551215007EA3348XCTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,642 CHIROPRACTIC in MN

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Provider Addresses for DR. JAY L. PETTIS (D.C.)

  • 1570, Century Point, Eagan, Dakota County, Minnesota, 55121, United States

    EAGAN, MN 55121

    Phone: (651) 405-3990

    Fax: (651) 405-6627

    Mailing address matches the actual address.

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: 2006-09-21

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060921000394IChiropracticMNTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55121)

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Reviews

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Frequently asked questions

What number should I use to identify DR. JAY L. PETTIS (D.C.) for billing?
Administrative and clinical systems typically use NPI 1548215320 for DR. JAY L. PETTIS (D.C.).
Is DR. JAY L. PETTIS (D.C.)'s NPI status active today?
Active status means DR. JAY L. PETTIS (D.C.)'s NPI record is not deactivated in the public file.
What type of care does DR. JAY L. PETTIS (D.C.) provide?
DR. JAY L. PETTIS (D.C.)'s profile centers on Chiropractor. Clinical services aligned with this taxonomy classification.
What city is tied to DR. JAY L. PETTIS (D.C.)?
The directory associates DR. JAY L. PETTIS (D.C.) with Eagan, Minnesota. Check all listed addresses for suites or satellite offices.
Can I export DR. JAY L. PETTIS (D.C.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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