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NASTASSIA MARIE PAVLOV
NPI 1609284033
Counselor - Mental Health in Minneapolis, MN

Active since July 29, 2014PECOS EnrolledAccepts Medicare Assignment
410 CHURCH ST SE, MINNEAPOLIS, MN 55455(612) 225-8400 Get Directions Write a Review

NPPES record last updated: January 13, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 13, 2020, Apr 27, 2018 (2 updates tracked since 2018).

About Nastassia Marie Pavlov NPPES

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

NASTASSIA MARIE PAVLOV (NPI 1609284033) is an individual mental health provider in Minneapolis, Minnesota, licensed in Minnesota (3675) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1609284033
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameNASTASSIA MARIE PAVLOV
Location Address410 CHURCH ST SEMinneapolis, MN 55455-0222
Mailing Address401 Church St, 401 Church St.Minneapolis, MN 55455 · (612) 626-3507 · Fax (612) 625-6800
Phone(612) 225-8400
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateJuly 29, 2014
Last NPPES UpdateJanuary 13, 20202 updates tracked since enumeration
✔ NPI 1609284033 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MN · 3675
410 CHURCH ST SE, Minneapolis, MN 55455
Open in Google Maps ↗

Secondary Practice Locations 2

Location 17041 20th AveCenterville, MN 55038-9737 · Phone (651) 407-3631 · Fax (651) 407-3751
Location 2401 Church St SEMinneapolis, MN 55455 · Phone (612) 626-3507 · Fax (612) 625-6800

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nastassia Marie Pavlov 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 ID2466803762
PECOS Enrollment IDI20240111001579
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.

Medicare Billing Reassignment

Medicare enrollment records show Nastassia Pavlov reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Nystrom & Associates, Ltd
7.5 mi
Clinical
1900 SILVER LAKE RD NW, SUITE 110
New Brighton, MN 55112
  • Reassigned Medicare billing, Minnesota enrollment
  • 794 clinicians in this Medicare group
NPI 1396750188 (651) 628-9566

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. STEPHANIE GRADY PA & NP
Family Medicine
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-2612
RICHARD JON FEIST MD
Family Medicine
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-8400
REGENTS OF THE UNIVERSITY OF MINNESOTA
Clinic/Center (Student Health)
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-8400
JEREMY ADAM GOLDBERG LICSW
Social Worker (Clinical)
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 624-1444
DR. SABA GHAZIMOGHADAM PH.D.
Psychologist (Counseling)
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-8400
JOY L JOHNSON-LIND LICSW
Social Worker (Clinical)
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-8400
MARY KATHERINE UTZ LICSW
Social Worker (Clinical)
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 624-9194
MARILYN SUSAN JOSEPH MD
Obstetrics & Gynecology
410 CHURCH ST SE, BOYNTON HEALTH SERVICE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-5187

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 Nastassia Pavlov's NPI number?

The NPI number for Nastassia Pavlov is 1609284033. It was assigned to this individual provider in the NPPES registry on July 29, 2014.

Where is Nastassia Pavlov located?

Nastassia Pavlov practices at 410 Church St SE, Minneapolis, MN 55455. The listed phone number is (612) 225-8400.

What is Nastassia Pavlov's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Nastassia Pavlov enrolled in Medicare?

Yes. Nastassia Pavlov is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Nastassia Pavlov's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nastassia Pavlov reassigns Medicare benefits to Nystrom & Associates, Ltd (New Brighton, MN). The 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 Nastassia Pavlov's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nastassia Pavlov accept?

Health plans from HealthPartners list Nastassia Pavlov 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 Nastassia Pavlov was last updated on January 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.