JODY ANN MIKKELSON (PA-C) – Physician Assistant, NPI 1669400156
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
4,031 PHYSICIAN ASSISTANT in MN
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Provider Addresses for JODY ANN MIKKELSON (PA-C)
9825, Hospital Drive, The Grove, Maple Grove, Hennepin County, Minnesota, 55369, United States
SUITE 300
MAPLE GROVE, MN 55369
Phone: (763) 587-7900
Fax: (763) 587-7989
Type: Mailing
9201 W BROADWAY AVE STE 601
BROOKLYN PARK, MN 554451924
Phone: (763) 587-7900
Fax: (763) 587-7066
Type: Mailing
9825 HOSPITAL DR STE 300
MAPLE GROVE, MN 553694768
Phone: (763) 587-7900
Fax: (763) 494-7501
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $125.
Total Amount is formed as General ($125) + Research ($0) + Ownership ($0) = $125.
Last reported payment date: 2023-09-26 • Largest payer in this snapshot: Dexcom, Inc. ($125).
Total Amount
$125
General + Research + Ownership
Payments
1
Total payment records
General Amount
$125
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dexcom, Inc. | $125 |
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: 2008-10-09
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 |
|---|---|---|---|---|
| I20081009000805 | 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 |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 121 | 71 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 99 | 68 | $0 |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 67 | 51 | $0 |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 57 | 48 | $0 |
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 34 | 29 | $0 |
Insurance plans in this area (ZIP 55369)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| Colorectal Surgery (Proctology) | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| Family Practice | MN | |
| Internal Medicine, Rheumatology | MN | |
| Nurse Practitioner | MN | |
| Family Practice | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| Colorectal Surgery (Proctology) | MN | |
| Internal Medicine, Gastroenterology | MN |
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