MS. SUSAN THOMA RAUCKMAN (ANP-BC) – Adult Health Nurse Practitioner, NPI 1669642260
Adult Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for MS. SUSAN THOMA RAUCKMAN (ANP-BC)
1 SAINT ELIZABETH BLVD
O FALLON, IL 622691099
Phone: (618) 234-2120
Fax: (618) 223-5741
Type: Mailing
6000 BOND AVE
CENTREVILLE, IL 622072328
Phone: (618) 332-2083
Fax: (618) 337-6039
Type: Location
211, South 3rd Street, Belleville, Saint Clair County, Illinois, 62220, United States
BELLEVILLE, IL 622201915
Phone: (618) 234-2120
Fax: (618) 222-4761
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $200.
Total Amount is formed as General ($200) + Research ($0) + Ownership ($0) = $200.
Last reported payment date: 2024-12-04 • Largest payer in this snapshot: Alkermes, Inc. ($101).
Total Amount
$200
General + Research + Ownership
Payments
8
Total payment records
General Amount
$200
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alkermes, Inc. | $101 |
| Teva Pharmaceuticals USA, Inc. | $50 |
| Janssen Pharmaceuticals, Inc | $49 |
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: 2010-11-03
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 |
|---|---|---|---|---|
| I20101103000117 | I | Nurse Practitioner | IL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62269)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | IL | |
| Mental Health Counselor | IL | |
| Clinical Social Worker | IL | |
| Cardiovascular Disease (Cardiology) | IL | |
| Gastroenterology, Internal Medicine | MO | |
| Nurse Practitioner | IL | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | IL | |
| Internal Medicine, Cardiovascular Disease (Cardiology) | MO | |
| Internal Medicine | IL | |
| P S Y C H I A T R Y | IL |
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