SUSAN A DERRY (MD) – Emergency Medicine Physician, NPI 1023109030
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
270 EMERGENCY MEDICINE in ID
Provider Addresses for SUSAN A DERRY (MD)
25 Jacobs Gulch Rd
Kellogg, ID 838372023
Phone: (208) 625-4000
Type: Location
Lacey Square, Cashel, The Municipal District of Cahir — Cashel, County Tipperary, Munster, E25 RD21, Ireland
LACEY, WA 985095007
Phone: (360) 918-0119
Type: Mailing
Providence St. Peter Hospital, 413, Lilly Road Northeast, Olympia, Thurston County, Washington, 98506, United States
MSDDH09
OLYMPIA, WA 985065133
Phone: (360) 918-0119
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: 2024-10-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20151106001129 | I | Emergency Medicine | WA | TBD |
| I20231222002110 | I | Emergency Medicine | MN | TBD |
| I20240212002237 | I | Emergency Medicine | NE | TBD |
| I20241016004316 | I | Emergency Medicine | ID | 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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 186 | 182 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 153 | 139 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 43 | 43 | $0 |
| 99291 | Critical care, first 30-74 minutes | 42 | 42 | $0 |
| 93042 | Electrocardiogram (ecg) 1 to 3 leads with review by physician only | 20 | 20 | $0 |
Insurance plans in this area (ZIP 83837)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| EMERGENCY MEDICINE | WA | 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 277 | 261 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | TX | |
| Emergency Medicine | MI | |
| Emergency Medicine | IN | |
| Family Practice, Emergency Medicine | OR | |
| - | WA | |
| Emergency Medicine | OR | |
| Emergency Medicine | WA | |
| Emergency Medicine | WA | |
| - | NY | |
| - | WA |
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