PATRICIA J. MACTAGGERT (M.A.,L.P.) – Psychologist, NPI 1710016043
Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,813 MENTAL HEALTH COUNSELOR in MN
Provider Addresses for PATRICIA J. MACTAGGERT (M.A.,L.P.)
PO BOX 819
WAYZATA, MN 553910819
Phone: (612) 803-2533
Type: Mailing
804 LAKE ST E
SUITE 204
WAYZATA, MN 553911980
Phone: (612) 803-2533
Type: Location
2301 LOST LAKE CT
MOUND, MN 553644512
Phone: (612) 803-2533
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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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: 2025-10-01
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 |
|---|---|---|---|---|
| I20251001001807 | I | Mental Health Counselor | 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.
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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 55391)
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