MICHELLE REYNOLDS (MD) – Student in an Organized Health Care Education/Training Program, NPI 1669906053

MICHELLE REYNOLDS (MD) is a healthcare provider. based in Tyler, Minnesota. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 68255 (MN). The NPI Number for MICHELLE REYNOLDS (MD) is 1669906053

Main info

Female
9 Years Of Experience
Name
MICHELLE REYNOLDS (MD)
NPI
1669906053
Phone
Not provided
Address
240 WILLOW ST
Enumeration Date
12 April 2017
Last Update Date
2 October 2020

Doctor Profile

Medical School Name
WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5072475521
Graduation Year
2017 (9 years ago)
PAC ID
8123398807
Group Practice PAC ID
9638088537
Professional Enrollment ID
I20210125000422
Address ID
MN561781201TY240XXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:9State licenses:1Digital endpointsOther names

3,075 FAMILY PRACTICE in MN

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Provider Addresses for MICHELLE REYNOLDS (MD)

  • Avera Tyler Hospital, 240, Willow Street, Tyler, Lincoln County, Minnesota, 56178, United States

    TYLER, MN 561781201

    Phone:

    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: 2021-01-25

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
I20210125000422IFamily PracticeMNTBD

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 56178)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638088537View full group profile
NameSpecialtyState
Physician AssistantMN
Family PracticeMN
Internal Medicine, Endocrinology, EndocrinologyMN
Nurse PractitionerMN
-MN
Nurse PractitionerMN
Nurse PractitionerMN
-TN
General SurgeryMN
Nurse PractitionerMN

Reviews

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Frequently asked questions

Is MICHELLE REYNOLDS (MD) listed with a National Provider Identifier?
Yes — MICHELLE REYNOLDS (MD) has NPI 1669906053 on file in the registry.
Is there an active status for MICHELLE REYNOLDS (MD)?
For scheduling context, MICHELLE REYNOLDS (MD) is shown as active in the registry.
What clinical focus is listed for MICHELLE REYNOLDS (MD)?
At a glance, MICHELLE REYNOLDS (MD) is tied to Student in an Organized Health Care Education/Training Program. Clinical services aligned with this taxonomy classification.
Where in Minnesota is MICHELLE REYNOLDS (MD) registered?
Use Tyler, Minnesota as the headline location for MICHELLE REYNOLDS (MD) here.
When was this NPI issued?
Enumeration for MICHELLE REYNOLDS (MD) is noted as April 12, 2017 where the registry provides it.

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