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REBECCA EMILY WIERSMA
NPI 1780268045
Student in an Organized Health Care Education/Training Program in Minneapolis, MN

Active since May 11, 2021PECOS Enrolled
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 624-4477 Get Directions Write a Review

NPPES record last updated: June 10, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 10, 2025, Apr 23, 2024, May 11, 2021 (3 updates tracked since 2021).

About Rebecca Emily Wiersma NPPES

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

REBECCA EMILY WIERSMA (NPI 1780268045) is an individual student in an organized health care education/training program in Minneapolis, Minnesota, licensed in Minnesota (76511) and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780268045
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameREBECCA EMILY WIERSMA
Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450
Mailing Address2450 Riverside AveMinneapolis, MN 55454-1450 · (612) 624-3113
Phone(612) 624-4477
Sole ProprietorNo
Enumeration DateMay 11, 2021
Last NPPES UpdateJune 10, 20253 updates tracked since enumeration
NPPES CertifiedJune 10, 2025
✔ NPI 1780268045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in MN · 76511
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2450 RIVERSIDE AVE, Minneapolis, MN 55454
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Rebecca Emily Wiersma is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignments

2

Medicare enrollment records show Rebecca Wiersma reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fairview Health Services
Same address
General Acute Care Hospital
2450 RIVERSIDE AVE, OUTREACH LAB DEPARTMENT
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 4,038 clinicians in this Medicare group
NPI 1316008212 (612) 273-7838
Fairview Clinics
0.1 mi
Clinic/Center
606 24TH AVE S, STE 602
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,302 clinicians in this Medicare group
NPI 1043516867 (612) 273-6099

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.

MICHELLE IRENE GRAY
Rehabilitation Practitioner
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
DR. KATHLEEN F SADAK MD
Pediatrics
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-6402
DR. ADMATHA MUTHYALA WINFRED MD
Internal Medicine (Geriatric Medicine)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
KELLY SCHELLER WILLIAMS
Dietitian, Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-3216
MRS. MARY SUSAN CLIPP CPNP-AC
Nurse Practitioner (Pediatrics, Critical Care)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 365-3100
DANIEL TESFAYE KEBED MD
Internal Medicine
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MS. CHELSEA ANJELICA MIELKE PA-C
Physician Assistant
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MRS. JESSICA LYNN MCADAM
Nurse Anesthetist, Certified Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-8383

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 Rebecca Wiersma's NPI number?

The NPI number for Rebecca Wiersma is 1780268045. It was assigned to this individual provider in the NPPES registry on May 11, 2021.

Where is Rebecca Wiersma located?

Rebecca Wiersma practices at 2450 Riverside Ave, Minneapolis, MN 55454. The listed phone number is (612) 624-4477.

What is Rebecca Wiersma's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Rebecca Wiersma enrolled in Medicare?

Yes. Rebecca Wiersma is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Rebecca Wiersma's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Rebecca Wiersma reassigns Medicare benefits to 2 organizations: Fairview Health Services (Minneapolis, MN) and Fairview Clinics (Minneapolis, MN). Each 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 Rebecca Wiersma's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Rebecca Wiersma was last updated on June 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.