SUSAN BOEKEL (RD, LD, IBCLC) – Registered Dietitian, NPI 1376090415

SUSAN BOEKEL (RD, LD, IBCLC) is a healthcare provider. based in Watkinsville, Georgia. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold the professional credentials RD, LD, IBCLC. They hold a License No. LD001047 (GA). The NPI Number for SUSAN BOEKEL (RD, LD, IBCLC) is 1376090415

Main info

Female
Sole Proprietor
44 Years Of Experience
Accepts Medicare Assignment
Name
SUSAN BOEKEL (RD, LD, IBCLC)
NPI
1376090415
Phone
Not provided
Address
1551 JENNINGS MILL RD UNIT 2900A
Enumeration Date
7 September 2016
Last Update Date
12 January 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4047250808
Graduation Year
1982 (44 years ago)
PAC ID
1759637556
Group Practice PAC ID
4183868326
Professional Enrollment ID
I20180716003162
Address ID
GA306774917WA1026XPLXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:9State licenses:1Digital endpointsOther names

115 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in GA

Provider Addresses for SUSAN BOEKEL (RD, LD, IBCLC)

  • 1551 JENNINGS MILL RD UNIT 2900A

    WATKINSVILLE, GA 306777254

    Phone:

    Mailing address matches the actual address.

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: 2024-07-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20180716003162IRegistered Dietitian Or Nutrition ProfessionalGATBD
I20240702000584IRegistered Dietitian Or Nutrition ProfessionalTXTBD

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 30677)

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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: 4183868326View full group profile
NameSpecialtyState
Registered Dietitian Or Nutrition ProfessionalGA
Registered Dietitian Or Nutrition ProfessionalGA
Registered Dietitian Or Nutrition ProfessionalGA

Reviews

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Frequently asked questions

What NPI should I save for SUSAN BOEKEL (RD, LD, IBCLC)?
Save NPI 1376090415 if you need a stable reference for SUSAN BOEKEL (RD, LD, IBCLC).
Is SUSAN BOEKEL (RD, LD, IBCLC)'s NPI currently valid?
The extract we use shows SUSAN BOEKEL (RD, LD, IBCLC) as active.
What does SUSAN BOEKEL (RD, LD, IBCLC) treat or focus on?
Patients typically see SUSAN BOEKEL (RD, LD, IBCLC) under the specialty Registered Dietitian. Clinical services aligned with this taxonomy classification.
Does SUSAN BOEKEL (RD, LD, IBCLC) practice in Georgia?
You will see Watkinsville, Georgia on file for SUSAN BOEKEL (RD, LD, IBCLC) alongside any extra practice locations.
Is SUSAN BOEKEL (RD, LD, IBCLC) a real provider?
This page reflects official NPPES data for NPI 1376090415. Always confirm identity and privileges with the practice and licensing boards.

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