ASSOCIATED NEPHROLOGY CONSULTANTS, P.A. – Nephrology Physician, NPI 1104976158
Nephrology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for ASSOCIATED NEPHROLOGY CONSULTANTS, P.A.
1997, Sloan Place, Maplewood, Ramsey County, Minnesota, 55117, United States
SUITE 17
MAPLEWOOD, MN 551172051
Phone: (651) 772-6251
Fax: (651) 224-9661
Type: Location
1997 SLOAN PL STE 17
MAPLEWOOD, MN 551172051
Phone: (651) 772-6251
Fax: (651) 224-9661
Type: Location
Hwy 55, Floyd B. Olson Memorial Highway/Hiawatha Pioneer Trail, Eagan, Dakota County, Minnesota, 55121-1542, United States
SUITE 130
EAGAN, MN 551211447
Phone: (651) 842-3378
Fax: (651) 224-5273
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: 2009-08-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-01-31 (130 days ago).
Enrollment records
2
Earliest due date
2026-01-31
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 |
|---|---|---|---|---|
| O20081020000483 | O | Clinic/Group Practice | WI | 2026-01-31 |
| O20090827000310 | O | Clinic/Group Practice | MN | 2026-02-28 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55117)
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