MERCY MIANTONA – Psychiatric/Mental Health Nurse Practitioner, NPI 1952838997

MERCY MIANTONA is a healthcare provider. based in Brooklyn park, Minnesota. specializing in NURSE PRACTITIONER. They hold a License No. F05170156 (MN). The NPI Number for MERCY MIANTONA is 1952838997

Main info

Female
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
MERCY MIANTONA
NPI
1952838997
Phone
(763) 400-6376
Address
6300 EDGEMONT BLVD N
Enumeration Date
22 May 2017
Last Update Date
12 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6514337207
Graduation Year
2017 (9 years ago)
PAC ID
6103197967
Group Practice PAC ID
3678998796
Professional Enrollment ID
I20170812000396
Address ID
MN551091320MA2785XNXXX501
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness85
Years active:9State licenses:2Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

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Provider Addresses for MERCY MIANTONA

  • 6300, Edgemont Boulevard North, Brooklyn Park, Hennepin County, Minnesota, 55428, United States

    BROOKLYN PARK, MN 554281844

    Phone: (763) 400-6376

    Type: Mailing

  • 5801, Brooklyn Boulevard, Brooklyn Center, Hennepin County, Minnesota, 55429, United States

    BROOKLYN CENTER, MN 554292521

    Phone: (866) 389-2727

    Type: Location

  • 2785 WHITE BEAR AVE N STE 105

    MAPLEWOOD, MN 551091320

    Phone: (651) 433-7207

    Fax: (651) 410-1502

    Type: Mailing

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: 2017-08-12

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
I20170812000396INurse 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes7118$0
View full utilization report →

Insurance plans in this area (ZIP 55428)

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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: 3678998796View full group profile
NameSpecialtyState
P S Y C H I A T R YMN
Nurse PractitionerMN

Reviews

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Frequently asked questions

How is MERCY MIANTONA identified in CMS data?
CMS-hosted NPPES data lists MERCY MIANTONA with NPI 1952838997.
Is MERCY MIANTONA listed as active for patients and plans?
The listing shows MERCY MIANTONA as active in the NPI system.
What is MERCY MIANTONA's primary classification?
Psychiatric/Mental Health Nurse Practitioner is the headline specialty for MERCY MIANTONA here. Clinical services aligned with this taxonomy classification.
Where is MERCY MIANTONA based?
MERCY MIANTONA is tied to Brooklyn Park, Minnesota in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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