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MRS. ADRIANA ADDISON FNP-BC
NPI 1902053952
Nurse Practitioner - Family in Pine City, MN

Active since August 21, 2008PECOS Enrolled
100 EVERGREEN SQ SW, PINE CITY, MN 55063(320) 629-6721 Get Directions Write a Review

NPPES record last updated: January 22, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 22, 2019, Feb 21, 2018 (2 updates tracked since 2018).

About Mrs. Adriana Addison Fnp-bc NPPES

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

MRS. ADRIANA ADDISON FNP-BC (NPI 1902053952) is an individual family provider in Pine City, Minnesota, licensed in Minnesota (3164) and active in the NPI registry since August 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902053952
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. ADRIANA ADDISONCredential: FNP-BC
Location Address100 EVERGREEN SQ SWPine City, MN 55063-2000
Mailing Address257 W Saint George AveGrantsburg, WI 54840-7827 · (715) 463-5317
Phone(320) 629-6721
Sole ProprietorNo
Enumeration DateAugust 21, 2008
Last NPPES UpdateJanuary 22, 20192 updates tracked since enumeration
✔ NPI 1902053952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in MN · 3164✔ Licensed in WI · 3647
Also ListedRegistered NurseTaxonomy 163W00000X · License 160486-30 (WI)
100 EVERGREEN SQ SW, Pine City, MN 55063
Open in Google Maps ↗

Other Identifiers 2

Medicaid190205392WI
Medicaid190205392MN

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Adriana Addison Fnp-bc 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 Adriana Addison reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fairview Clinics
Same address
Primary Care
100 EVERGREEN SQ SW
Pine City, MN 55063
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,302 clinicians in this Medicare group
NPI 1477781375 (320) 629-6721
Fairview Health Services
35 mi
General Acute Care Hospital
5200 FAIRVIEW BLVD
Wyoming, MN 55092
  • Reassigned Medicare billing, Minnesota enrollment
  • 4,038 clinicians in this Medicare group
NPI 1083692941 (651) 982-7000

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 55063 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 6

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

SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
100 EVERGREEN SQ SW
PINE CITY, MN 55063
Pine County (320) 629-3003
AMBER L CALLAHAN PHARMD.
Pharmacist
100 EVERGREEN SQ SW
PINE CITY, MN 55063
Pine County (320) 629-3003
UMAIR REHMAN MD
Family Medicine
100 EVERGREEN SQ SW
PINE CITY, MN 55063
Pine County (320) 629-6721
FAIRVIEW CLINICS
Clinic/Center (Primary Care)
100 EVERGREEN SQ SW
PINE CITY, MN 55063
Pine County (320) 629-6721
KATHRYN MARVIN NP
Nurse Practitioner (Family)
100 EVERGREEN SQ SW
PINE CITY, MN 55063
Pine County (320) 629-6721
WHITNEY RENE MOULTON DPT
Physical Therapist
100 EVERGREEN SQ SW
PINE CITY, MN 55063
Pine County (320) 629-8575

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 Adriana Addison's NPI number?

The NPI number for Adriana Addison is 1902053952. It was assigned to this individual provider in the NPPES registry on August 21, 2008.

Where is Adriana Addison located?

Adriana Addison practices at 100 Evergreen Sq SW, Pine City, MN 55063. The listed phone number is (320) 629-6721.

What is Adriana Addison's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Adriana Addison enrolled in Medicare?

Yes. Adriana Addison is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Adriana Addison's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Adriana Addison reassigns Medicare benefits to 2 organizations: Fairview Clinics (Pine City, MN) and Fairview Health Services (Wyoming, 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 Adriana Addison'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 Adriana Addison was last updated on January 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.