KELLY E PEZZELLA (NP) – Family Nurse Practitioner, NPI 1679879241
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,720 NURSE PRACTITIONER in MN
Provider Addresses for KELLY E PEZZELLA (NP)
4152 COLUMBUS AVENUE
MINNEAPOLIS, MN 55407
Phone: (651) 641-0435
Type: Mailing
1600 GRAND AVE
MACALESTER COLLEGE HEALTH AND WELLNESS CENTER
SAINT PAUL, MN 551051801
Phone: (651) 696-6275
Type: Location
701 PARK AVE
MINNEAPOLIS, MN 554151623
Phone: (612) 873-3000
Type: Mailing
2810 NICOLLET AVE
MINNEAPOLIS, MN 554084708
Phone: (612) 873-6963
Type: Location
1200 CEDAR LAKE RD S
MINNEAPOLIS, MN 554163606
Phone: (651) 641-0435
Type: Mailing
19685 PILOT KNOB RD
FARMINGTON, MN 550247238
Phone: (651) 602-7500
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: 2012-06-26
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 |
|---|---|---|---|---|
| I20120626000762 | I | Nurse Practitioner | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 44 | 24 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 14 | 13 | $0 |
Insurance plans in this area (ZIP 55407)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E P H R O L O G Y | MN | |
| Hematology/Oncology, Internal Medicine | MN | |
| - | MN | |
| Nurse Practitioner | MN | |
| - | MN | |
| - | TN | |
| Emergency Medicine | MN | |
| Nurse Practitioner | MN | |
| Physician Assistant | MN | |
| - | MN |
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