RICHARD GORDON NELLIS (PA-C) – Physician Assistant, NPI 1649438516
Physician Assistant
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,032 PHYSICIAN ASSISTANT in MN
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Provider Addresses for RICHARD GORDON NELLIS (PA-C)
6582, 145th Cir N, Hugo, Washington County, Minnesota, 55038, United States
HUGO, MN 550386000
Phone: (612) 327-2732
Type: Mailing
Fairview Lakes Medical Center, 5200, Fairview Boulevard, Wyoming, Chisago County, Minnesota, 55092, United States
WYOMING, MN 550928013
Phone: (651) 982-7000
Type: Location
3065 Route 50 Ste 30
Saratoga Springs, NY 128662920
Phone: (518) 886-5800
Type: Location
20449 Koglin Rd
Hutchinson, MN 553504332
Phone: (612) 327-2732
Type: Location
20449 KOGLIN RD
HUTCHINSON, MN 553504332
Phone: (612) 327-2732
Type: Location
104 HEIGHTS RD # R103
DARIEN, CT 068204119
Phone: (888) 663-6331
Fax: (415) 252-7176
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: 2025-01-31
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 16 Medicare enrollment records; no due dates published yet.
Enrollment records
16
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 |
|---|---|---|---|---|
| I20081027000763 | I | Physician Assistant | MN | TBD |
| I20211005000931 | I | Physician Assistant | MI | TBD |
| I20211103000057 | I | Physician Assistant | ME | TBD |
| I20211103000312 | I | Physician Assistant | NY | TBD |
| I20211104001508 | I | Physician Assistant | KS | TBD |
| I20211109003059 | I | Physician Assistant | WI | TBD |
| I20211110003056 | I | Physician Assistant | OH | TBD |
| I20211111002870 | I | Physician Assistant | FL | TBD |
| I20211112002252 | I | Physician Assistant | KY | TBD |
| I20211116000565 | I | Physician Assistant | IL | TBD |
| I20211116000842 | I | Physician Assistant | NJ | TBD |
| I20211116000956 | I | Physician Assistant | PA | TBD |
| I20220907001538 | I | Physician Assistant | MO | TBD |
| I20240823001326 | I | Physician Assistant | MA | TBD |
| I20240830001537 | I | Physician Assistant | TX | TBD |
| I20250131000502 | I | Physician Assistant | CO | 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 |
|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 15 | 15 | $0 |
Insurance plans in this area (ZIP 55038)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | DE | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | NH | |
| Nurse Practitioner | CT | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | PA | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | NC |
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