NORTHWAY ACADEMY, INC.
NPI 1114539434
Community/Behavioral Health in Elk River, MN
About Northway Academy, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NORTHWAY ACADEMY, INC. (NPI 1114539434) is a healthcare organization registered as a community/behavioral health in Elk River, Minnesota and active in the NPI registry since August 2020. The organization lists Mary Patricia Rodenberg-roberts, Vp & Sr Asst Gc, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Northway Academy, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Northway Academy, Inc., which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Northway Academy, Inc.'s NPI number?
The NPI number for Northway Academy, Inc. is 1114539434. It was assigned to this organization in the NPPES registry on August 18, 2020.
Where is Northway Academy, Inc. located?
Northway Academy, Inc. is located at 19437 Evans Street NW, Elk River, MN 55330. The listed phone number is (320) 290-0693.
What is Northway Academy, Inc.'s specialty?
The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.
Is Northway Academy, Inc. enrolled in Medicare?
Yes. Northway Academy, Inc. is registered in the Medicare PECOS enrollment system.
When is Northway Academy, Inc.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Minnesota, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Northway Academy, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Northway Academy, Inc., in Occupational Therapist in Private Practice and Physical Therapist in Private Practice. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Northway Academy, Inc. accept?
Health plans from Sanford Health Plan list Northway Academy, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Northway Academy, Inc. was last updated on January 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Northway Academy, Inc. · NPI 1114539434
Community/Behavioral Health organization in Elk River, Minnesota. Organization record, active in the CMS NPPES registry since August 18, 2020.
## Identity
- **NPI:** 1114539434 (Entity type: Organization)
- **Enumerated:** August 18, 2020
- **Primary specialty:** Community/Behavioral Health · taxonomy 251S00000X
- **Organization subpart:** No
- **Authorized official:** Mary Rodenberg-Roberts, VP & SR ASST GC
## Practice location
- **Address:** 19437 EVANS STREET NW, Elk River, MN 55330-1074
- **Phone:** (320) 290-0693 · **Fax:** (952) 945-4918
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Minnesota, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Occupational Therapist in Private Practice (1), Physical Therapist in Private Practice (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 23, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1114539434) · Data from the CMS NPPES public registry.