MRS. MELISSA SUE BRUSACORAM (APRN, CNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1962051359
Psychiatric/Mental Health Nurse Practitioner
Main info
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Profile Insights
NPPES metrics only — not quality of care.
5,720 NURSE PRACTITIONER in MN
Provider Addresses for MRS. MELISSA SUE BRUSACORAM (APRN, CNP)
6145 KROGERUS RD
CHISHOLM, MN 557198059
Phone: (218) 296-0688
Type: Mailing
7478 GREEN ROCK RD
SIDE LAKE, MN 557818434
Phone: (218) 296-0688
Type: Mailing
118 W LAKE ST
CHISHOLM, MN 557191819
Phone: (218) 254-0101
Fax: (844) 921-1071
Type: Location
516, South Pokegama Avenue, Grand Rapids, Itasca County, Minnesota, 55744, United States
GRAND RAPIDS, MN 557443800
Phone: (218) 327-2001
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $69.
Total Amount is formed as General ($69) + Research ($0) + Ownership ($0) = $69.
Last reported payment date: 2024-11-20 • Largest payer in this snapshot: Tempus AI, Inc ($53).
Total Amount
$69
General + Research + Ownership
Payments
3
Total payment records
General Amount
$69
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Tempus AI, Inc | $53 |
| Supernus Pharmaceuticals, Inc. | $16 |
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: 2020-06-10
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 |
|---|---|---|---|---|
| I20200610002877 | 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 | 66 | 27 | $0 |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | 51 | 22 | $0 |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 13 | 13 | $0 |
Insurance plans in this area (ZIP 55719)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MN | |
| Nurse Practitioner | WI | |
| Nurse Practitioner | WY | |
| Nurse Practitioner | MN |
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