BRIANNA LEIGH THOMALLA CNP
NPI 1417539057
Nurse Practitioner - Women's Health in Clear Lake, MN

Active since April 23, 2021PECOS EnrolledAccepts Medicare Assignment
4902 115TH AVE, CLEAR LAKE, MN 55319(320) 333-6109 Get Directions Write a Review

NPPES record last updated: April 23, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Brianna Leigh Thomalla Cnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRIANNA LEIGH THOMALLA CNP (NPI 1417539057) is an individual women's health provider in Clear Lake, Minnesota, licensed in Minnesota (8026) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1417539057
Entity TypeIndividualFemale
Primary Taxonomy363LW0102X
Provider Legal NameBRIANNA LEIGH THOMALLACredential: CNP
Location Address4902 115TH AVEClear Lake, MN 55319-9793
Mailing Address4902 115th AveClear Lake, MN 55319-9793 · (132) 033-3610
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateApril 23, 2021
NPPES CertifiedApril 23, 2021
NPI 1417539057 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Women's HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LW0102X
License Licensed in MN · 8026
4902 115TH AVE, Clear Lake, MN 55319

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Brianna Leigh Thomalla Cnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6002211265
PECOS Enrollment IDI20210826000009
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55319 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417539057, enumerated as an "individual" on April 23, 2021.

The provider is located at 4902 115TH AVE CLEAR LAKE, MN 55319 and the phone number is (320) 333-6109.

Nurse Practitioner with taxonomy code 363LW0102X and a focus in Women's Health.

The provider might be accepting Accepts: HealthPartners, Medica and Sanford Health Plan. Please consult your insurance carrier or call the provider to verify.