SUZANNE WATTS DEDMORE (RN, FNP-C) – Family Nurse Practitioner, NPI 1013296326

SUZANNE WATTS DEDMORE (RN, FNP-C) is a healthcare provider. based in Santa rosa, California. specializing in NURSE PRACTITIONER. They hold the professional credentials RN, FNP-C. They hold a License No. 20520 (CA). The NPI Number for SUZANNE WATTS DEDMORE (RN, FNP-C) is 1013296326

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
SUZANNE WATTS DEDMORE (RN, FNP-C)
NPI
1013296326
Phone
(707) 303-3600
Address
3569 Round Barn Cir
Enumeration Date
4 August 2011
Last Update Date
26 July 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7073033600
Graduation Year
2010 (16 years ago)
PAC ID
9739310558
Group Practice PAC ID
0345130423
Professional Enrollment ID
I20240830001869
Address ID
CA954035781SA3569XCIRX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

Provider Addresses for SUZANNE WATTS DEDMORE (RN, FNP-C)

  • 3569 Round Barn Cir

    Santa Rosa, CA 954035781

    Phone: (707) 303-3600

    Type: Location

  • 3569 ROUND BARN CIR

    SANTA ROSA, CA 954035781

    Phone: (707) 303-3600

    Type: Mailing

  • 1110 N DUTTON AVE

    SANTA ROSA, CA 954014606

    Phone: (707) 303-3600

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-08-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240830001869INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95403)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345130423View full group profile
NameSpecialtyState
Family PracticeCA
Nurse PractitionerCA
Family PracticeCA
Family Practice, HospitalistCA
Family PracticeMA
Hospitalist, Family PracticeCA
Family PracticeCA
Nurse PractitionerNM
Family PracticeCA
Family PracticeCA

Reviews

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Frequently asked questions

Does SUZANNE WATTS DEDMORE (RN, FNP-C) have a public NPI I can cite?
Public records show SUZANNE WATTS DEDMORE (RN, FNP-C) under NPI 1013296326.
Is SUZANNE WATTS DEDMORE (RN, FNP-C) currently accepting referrals based on NPI status?
Registry metadata lists SUZANNE WATTS DEDMORE (RN, FNP-C) as active.
What services align with SUZANNE WATTS DEDMORE (RN, FNP-C)'s listing?
SUZANNE WATTS DEDMORE (RN, FNP-C)'s public classification highlights Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What geographic area is tied to SUZANNE WATTS DEDMORE (RN, FNP-C)?
SUZANNE WATTS DEDMORE (RN, FNP-C) is associated with Santa Rosa, California in the same public data insurers reference.
Who maintains SUZANNE WATTS DEDMORE (RN, FNP-C)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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