SHANA KATHLYN KONGSJORD (CNP) – Family Nurse Practitioner, NPI 1750606984
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,720 NURSE PRACTITIONER in MN
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Provider Addresses for SHANA KATHLYN KONGSJORD (CNP)
10th Avenue Northeast, Liston Evergreen Mobile Home Park, Deer River, Itasca County, Minnesota, 56636, United States
DULUTH CLINIC DEER RIVER
DEER RIVER, MN 566368703
Phone: (218) 246-8275
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: 2010-12-16
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 |
|---|---|---|---|---|
| I20101216001064 | 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 |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 17 | 17 | $0 |
| 77067 | Screening mammography | 11 | 11 | $0 |
| 77063 | Screening 3d breast mammography | 11 | 11 | $0 |
Insurance plans in this area (ZIP 56636)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | MT | |
| - | ND | |
| Physician Assistant | MN | |
| Nurse Practitioner | SD | |
| - | MN | |
| Qualified Audiologist | MN | |
| - | MN | |
| - | MN | |
| P A T H O L O G Y | WV | |
| Family Practice | MN |
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