ANNETTE PRIDEMORE MSW, LICSW
NPI 1639835473
Social Worker - Clinical in Minnetonka, MN
About Annette Pridemore Msw, Licsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANNETTE PRIDEMORE MSW, LICSW (NPI 1639835473) is an individual clinical provider in Minnetonka, Minnesota, licensed in Minnesota (27741) and active in the NPI registry since November 2021. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Annette Pridemore Msw, Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Annette Pridemore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Woodbury, MN 55125
- Reassigned Medicare billing, Minnesota enrollment
- 127 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55305 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
MINNETONKA, MN 55305
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 Annette Pridemore's NPI number?
The NPI number for Annette Pridemore is 1639835473. It was assigned to this individual provider in the NPPES registry on November 16, 2021. The provider is also known as Annette Fath Msw, Licsw.
Where is Annette Pridemore located?
Annette Pridemore practices at 3395 Plymouth Rd, Minnetonka, MN 55305. The listed phone number is (952) 565-5751.
What is Annette Pridemore's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Annette Pridemore enrolled in Medicare?
Yes. Annette Pridemore is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Annette Pridemore's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Annette Pridemore reassigns Medicare benefits to St. Croix Psychiatric, LLC (Woodbury, 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 Annette Pridemore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Annette Pridemore accept?
Health plans from HealthPartners and Medica list Annette Pridemore 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 Annette Pridemore was last updated on September 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 41 days 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.
# Annette Pridemore, MSW, LICSW · NPI 1639835473
Clinical provider in Minnetonka, Minnesota. Individual provider, active in the CMS NPPES registry since November 16, 2021.
## Identity
- **NPI:** 1639835473 (Entity type: Individual)
- **Enumerated:** November 16, 2021
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** 27741 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 3395 PLYMOUTH RD, Minnetonka, MN 55305-3765
- **Phone:** (952) 565-5751
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** St. Croix Psychiatric, LLC (NPI 1881849586, Woodbury, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 30, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1639835473) · Data from the CMS NPPES public registry.