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ELYSIA PETERSON PMHNP
NPI 1821448648
Nurse Practitioner - Psychiatric/Mental Health in Bloomington, MN

Active since June 13, 2016PECOS Enrolled
1801 AMERICAN BLVD E, BLOOMINGTON, MN 55425(952) 767-2267(952) 767-0782 Get Directions Write a Review

NPPES record last updated: October 4, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 4, 2024, Jul 29, 2019, Jun 13, 2016 (3 updates tracked since 2016).

About Elysia Peterson Pmhnp NPPES

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

ELYSIA PETERSON PMHNP (NPI 1821448648) is an individual psychiatric/mental health provider in Bloomington, Minnesota, licensed in Minnesota (CNP4557) and active in the NPI registry since June 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821448648
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameELYSIA PETERSONCredential: PMHNP
Location Address1801 AMERICAN BLVD EBloomington, MN 55425-1232
Mailing Address1801 American Blvd EBloomington, MN 55425-1232 · (952) 767-2267
Phone(952) 767-2267
Fax(952) 767-0782
Sole ProprietorYes
Enumeration DateJune 13, 2016
Last NPPES UpdateOctober 4, 20243 updates tracked since enumeration
NPPES CertifiedOctober 4, 2024
✔ NPI 1821448648 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in MN · CNP4557
1801 AMERICAN BLVD E, Bloomington, MN 55425
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elysia Peterson Pmhnp 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 Reassignment

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

Fraser Child And Family Center
7.9 mi
Adolescent and Children Mental Health
3333 UNIVERSITY AVE SE
Minneapolis, MN 55414
  • Reassigned Medicare billing, Minnesota enrollment
  • 228 clinicians in this Medicare group
NPI 1609922194 (612) 331-9413

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 55425 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.

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.

MICHAELA THOMAS
Behavior Technician
1801 AMERICAN BLVD E
BLOOMINGTON, MN 55425
Hennepin County (952) 767-2267
CHARLOTTE MOORE
Behavior Technician
1801 AMERICAN BLVD E
BLOOMINGTON, MN 55425
Hennepin County (651) 789-6375
ZHAMIAH BAILEY
Behavior Technician
1801 AMERICAN BLVD E
BLOOMINGTON, MN 55425
Hennepin County (952) 693-9623
DASON WILLIAM MATTHIESEN JR.
Behavior Technician
1801 AMERICAN BLVD E, SUITE B
BLOOMINGTON, MN 55425
Hennepin County (612) 331-9413
LYDIA NORMAN
Behavior Technician
1801 AMERICAN BLVD E
BLOOMINGTON, MN 55425
Hennepin County (952) 767-2267
KATHRYN ISABELLE MITCHELL
Behavior Technician
1801 AMERICAN BLVD E
BLOOMINGTON, MN 55425
Hennepin County (952) 767-2267
YASID PINO GUTIERREZ
Behavior Technician
1801 AMERICAN BLVD E
BLOOMINGTON, MN 55425
Hennepin County (952) 767-2267
SUREYA ALI
Behavior Technician
1801 AMERICAN BLVD E
BLOOMINGTON, MN 55425
Hennepin County (952) 767-2267

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 Elysia Peterson's NPI number?

The NPI number for Elysia Peterson is 1821448648. It was assigned to this individual provider in the NPPES registry on June 13, 2016.

Where is Elysia Peterson located?

Elysia Peterson practices at 1801 American Blvd E, Bloomington, MN 55425. The listed phone number is (952) 767-2267.

What is Elysia Peterson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Elysia Peterson enrolled in Medicare?

Yes. Elysia Peterson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Elysia Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elysia Peterson reassigns Medicare benefits to Fraser Child And Family Center (Minneapolis, 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 Elysia Peterson'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 Elysia Peterson was last updated on October 4, 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.