PAULA PATRICIA DAINE-DE BROUX (MA, LICSW, LCSW) – Clinical Social Worker, NPI 1588007512
Clinical Social Worker
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for PAULA PATRICIA DAINE-DE BROUX (MA, LICSW, LCSW)
1717 PARKSHORE DR APT 2101
ARDEN HILLS, MN 551123918
Phone: (612) 724-6200
Type: Mailing
4240 PARK GLEN RD
ST LOUIS PARK, MN 554165427
Phone: (612) 925-6033
Fax: (612) 925-8496
Type: Mailing
2501 HANLEY RD STE 101
HUDSON, WI 540168786
Phone: (715) 954-5300
Fax: (715) 954-5301
Type: Location
6550 YORK AVE S STE 417
EDINA, MN 554352336
Phone: (952) 426-3034
Fax: (612) 807-1773
Type: Mailing
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: 2020-04-29
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 |
|---|---|---|---|---|
| I20200429001731 | I | Clinical Social Worker | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55112)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pulmonary Disease | CO | |
| - | MN | |
| - | MN | |
| Family Practice | MN | |
| - | MO | |
| - | MN | |
| - | VA | |
| - | MN | |
| - | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN |
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