SUSAN G PAK (P.A.) – Physician Assistant, NPI 1366497703
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for SUSAN G PAK (P.A.)
PO BOX 10069
SAN BERNARDINO, CA 924230069
Phone: (909) 335-4188
Fax: (909) 796-4158
Type: Mailing
Highland Springs Avenue, Beaumont, Riverside County, California, United States
SUITE 200
BEAUMONT, CA 92223
Phone: (951) 845-0313
Fax: (909) 796-4158
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $208.
Total Amount is formed as General ($208) + Research ($0) + Ownership ($0) = $208.
Last reported payment date: 2023-06-14 • Largest payer in this snapshot: Boehringer Ingelheim Pharmaceuticals, Inc. ($173).
Total Amount
$208
General + Research + Ownership
Payments
5
Total payment records
General Amount
$208
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boehringer Ingelheim Pharmaceuticals, Inc. | $173 |
| PFIZER INC. | $18 |
| GlaxoSmithKline, LLC. | $17 |
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: 2007-03-22
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070322000335 | I | Physician Assistant | CA | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 96127 | Assessment of emotional or behavioral problems | 24 | 16 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 13 | 13 | $0 |
Insurance plans in this area (ZIP 92423)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CA | |
| - | CA | |
| U R O L O G Y | CA | |
| O P T O M E T R Y | CA | |
| - | CA | |
| - | CA | |
| - | CA | |
| Nurse Practitioner | CA | |
| - | CA | |
| - | CA |
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