GILLETTE CHILDREN'S SPECIALTY HEALTHCARE – Multi-Specialty Clinic/Center, NPI 1477612604
Multi-Specialty Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
1420, London Road, Duluth, Saint Louis County, Minnesota, 55805, United States
DULUTH, MN 558052433
Phone: (218) 728-6160
Fax: (218) 724-6982
Type: Location
1420 LONDON RD STE 210
DULUTH, MN 558052422
Phone: (218) 728-6160
Fax: (218) 724-6982
Type: Location
Gillette Children's Hospital and Clinics, 200, University Avenue East, Downtown, Saint Paul, Ramsey County, Minnesota, 55101, United States
SAINT PAUL, MN 551012507
Phone: (651) 291-2848
Fax: (651) 325-2174
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: 2021-01-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-01-31 (862 days ago).
Enrollment records
1
Earliest due date
2024-01-31
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 |
|---|---|---|---|---|
| O20210119001812 | O | Hospital | MN | 2024-01-31 |
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 55805)
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