MR. TROY MICHAEL EVENSON (PA C) – Physician Assistant, NPI 1609842632
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,031 PHYSICIAN ASSISTANT in MN
Provider Addresses for MR. TROY MICHAEL EVENSON (PA C)
4200 DAHLBERG DR STE 300
GOLDEN VALLEY, MN 554224841
Phone: (952) 512-5600
Type: Mailing
5601 96TH AVE N STE 200
BROOKLYN PARK, MN 554434505
Phone: (763) 786-9543
Fax: (763) 786-3320
Type: Location
Wayzata Blvd, South Wayzata Boulevard, Minneapolis, Hennepin County, Minnesota, 55416, United States
SUITE 900
MINNEAPOLIS, MN 554261728
Phone: (952) 512-5600
Fax: (952) 512-5651
Type: Mailing
Centennial Lakes Medical Center, 7373, France Avenue South, Centennial Lakes, Edina, Hennepin County, Minnesota, 55435-4534, United States
SUITE 312
EDINA, MN 554354534
Phone: (952) 832-0076
Fax: (952) 832-0477
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: 2004-02-19
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 |
|---|---|---|---|---|
| I20040219000173 | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 32 | 30 | $0 |
| 73562 | X-ray of knee, 3 views | 25 | 22 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 23 | 23 | $0 |
| 73630 | X-ray of foot, minimum of 3 views | 12 | 12 | $0 |
Insurance plans in this area (ZIP 55422)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | MN | 73562 | X-ray of knee, 3 views | 13 | 12 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MN | |
| Physical Therapist In Private Practice | MN | |
| Physical Therapist In Private Practice | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN | |
| - | MN | |
| Orthopedic Surgery | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN | |
| Physical Therapist In Private Practice | TX |
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