LYNN M TAIVAL (CPNP) – Pediatric Nurse Practitioner, NPI 1114988664
Pediatric Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for LYNN M TAIVAL (CPNP)
2910 CENTRE POINT DRIVE
35-121A
ROSEVILLE, MN 55113
Phone: (651) 855-2327
Fax: (651) 855-2310
Type: Mailing
Children's Minnesota - St. Paul Clinic, 347, North Smith Avenue, West Seventh - Fort Road, Saint Paul, Ramsey County, Minnesota, 55102, United States
CHILDRENS SPECIALTY CLINIC NICU FOLLOW UP CLINIC
ST PAUL, MN 55102
Phone: (651) 220-8063
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $178.
Total Amount is formed as General ($178) + Research ($0) + Ownership ($0) = $178.
Last reported payment date: 2023-08-08 • Largest payer in this snapshot: ABBVIE INC. ($178).
Total Amount
$178
General + Research + Ownership
Payments
4
Total payment records
General Amount
$178
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $178 |
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: 2004-11-17
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 |
|---|---|---|---|---|
| I20041117000910 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55113)
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