SUSIANI INTAN (MD) – Neuro-ophthalmology Physician, NPI 1114274529
Neuro-ophthalmology Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
466 OPHTHALMOLOGY in WA
Provider Addresses for SUSIANI INTAN (MD)
PO BOX 735044
CHICAGO, IL 606735044
Phone: (800) 326-2250
Type: Mailing
820 N CHELAN AVE
WENATCHEE, WA 988012028
Phone: (509) 663-8711
Type: Mailing
2801 W KINNICKINNIC RIVER PKWY
MILWAUKEE, WI 532153669
Phone: (414) 385-1922
Fax: (414) 385-1988
Type: Location
3301 W FOREST HOME AVE
MILWAUKEE, WI 532152843
Phone:
Type: Mailing
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: 2021-10-25
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 |
|---|---|---|---|---|
| I20211025001227 | I | Ophthalmology | WI | 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 |
|---|---|---|---|---|
| 92133 | Imaging of optic nerve | 76 | 58 | $0 |
| 92083 | Exam of visual field with extended testing | 74 | 55 | $0 |
| 92060 | Exam to measure eye deviation and range of motion | 62 | 54 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 40 | 34 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 39 | 31 | $0 |
Insurance plans in this area (ZIP 60673)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | WI | |
| Family Practice | WI | |
| H E M A T O L O G Y/ O N C O L O G Y | WI | |
| Hospitalist, Internal Medicine | WI | |
| Family Practice | WI | |
| Geriatric Medicine, Internal Medicine | WI | |
| - | WI | |
| Certified Registered Nurse Anesthetist (Crna) | WI | |
| Hospitalist, Internal Medicine | MI | |
| Obstetrics/Gynecology, Osteopathic Manipulative Medicine | WI |
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