DR. SENAYET GOITOM (DNP) – Nurse Practitioner, NPI 1679387054

DR. SENAYET GOITOM (DNP) is a healthcare provider. based in Blaine, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP. They hold a License No. 12484 (MN). The NPI Number for DR. SENAYET GOITOM (DNP) is 1679387054

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
DR. SENAYET GOITOM (DNP)
NPI
1679387054
Phone
(612) 499-2098
Address
8745 DAVENPORT ST NE
Enumeration Date
5 February 2025
Last Update Date
27 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6127878408
Graduation Year
2023 (3 years ago)
PAC ID
2062936982
Group Practice PAC ID
9335465558
Professional Enrollment ID
I20250411002093
Address ID
MN553312015EX464XXSTXX303
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:1State licenses:1Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for DR. SENAYET GOITOM (DNP)

  • 8745 DAVENPORT ST NE

    BLAINE, MN 554494229

    Phone: (612) 499-2098

    Type: Mailing

  • 464 2ND ST STE 204

    EXCELSIOR, MN 553312015

    Phone: (612) 787-8408

    Fax: (612) 567-8935

    Type: Location

  • 424 Church St Ste 2600

    Nashville, TN 372192379

    Phone: (480) 932-2741

    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: 2025-04-11

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
I20250411002093INurse PractitionerMNTBD

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 55449)

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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: 9335465558View full group profile
NameSpecialtyState
Nurse PractitionerMN
Nurse PractitionerMN
Nurse PractitionerMN
Pain Management, Physical Medicine And RehabilitationMN
Nurse PractitionerMN
-MN
Nurse PractitionerMN
Nurse PractitionerMN
Nurse PractitionerMN
Nurse PractitionerMN

Reviews

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Frequently asked questions

What NPI should I save for DR. SENAYET GOITOM (DNP)?
Save NPI 1679387054 if you need a stable reference for DR. SENAYET GOITOM (DNP).
Does this profile mean DR. SENAYET GOITOM (DNP) is currently active?
Yes — DR. SENAYET GOITOM (DNP) appears active in the national provider directory.
What does DR. SENAYET GOITOM (DNP) treat or focus on?
Patients typically see DR. SENAYET GOITOM (DNP) under the specialty Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where does public data place DR. SENAYET GOITOM (DNP)?
The snapshot lists Blaine, Minnesota for DR. SENAYET GOITOM (DNP); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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