NORTH MEMORIAL AMBULATORY SURGERY CENTER AT MAPLE GROVE, LLC – Ambulatory Surgical Clinic/Center, NPI 1316133044
Ambulatory Surgical Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for NORTH MEMORIAL AMBULATORY SURGERY CENTER AT MAPLE GROVE, LLC
9855, Hospital Drive, The Grove, Maple Grove, Hennepin County, Minnesota, 55369, United States
STE 175
MAPLE GROVE, MN 553694772
Phone: (763) 981-3200
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: 2007-11-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-04-30 (772 days ago).
Enrollment records
1
Earliest due date
2024-04-30
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 |
|---|---|---|---|---|
| O20071105000160 | O | Ambulatory Surgical Center | MN | 2024-04-30 |
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 67 | 67 | $0 |
| 64493 | Injection of lower or sacral spine facet joint using imaging guidance, single level | 52 | 17 | $0 |
| 45380 | Biopsy of large bowel using a flexible endoscope | 52 | 52 | $0 |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 49 | 49 | $0 |
| 45385 | Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 34 | 34 | $0 |
Insurance plans in this area (ZIP 55369)
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