KIMBERLY RAE SUDERMAN (LSCSW) – Social Worker, NPI 1801353875

KIMBERLY RAE SUDERMAN (LSCSW) is a healthcare provider. based in Manhattan, Kansas. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LSCSW. They hold a License No. 05804 (KS). The NPI Number for KIMBERLY RAE SUDERMAN (LSCSW) is 1801353875

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLY RAE SUDERMAN (LSCSW)
NPI
1801353875
Phone
(785) 629-3819
Address
330 POYNTZ AVE STE 205
Enumeration Date
26 February 2019
Last Update Date
5 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7855395455
Graduation Year
2017 (9 years ago)
PAC ID
2567844798
Group Practice PAC ID
2769574748
Professional Enrollment ID
I20220803003418
Address ID
KS665037603MA4201XAVEX307
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness85
Years active:7State licenses:1Digital endpointsOther names

833 CLINICAL SOCIAL WORKER in KS

Provider Addresses for KIMBERLY RAE SUDERMAN (LSCSW)

  • 330 POYNTZ AVE STE 205

    MANHATTAN, KS 665026194

    Phone: (785) 629-3819

    Type: Location

  • Westport Drive, Manhattan, Riley County, Kansas, 66502, United States

    MANHATTAN, KS 665022871

    Phone: (785) 560-3101

    Fax: (785) 527-8317

    Type: Location

  • 1329, 18th Street, Belleville, Republic County, Kansas, 66935, United States

    BELLEVILLE, KS 669352209

    Phone: (785) 560-3101

    Fax: (785) 527-8317

    Type: Mailing

  • 2001 CLAFLIN RD

    MANHATTAN, KS 665023415

    Phone: (785) 587-4300

    Fax: (785) 527-8317

    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: 2022-08-03

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220803003418IClinical Social WorkerKSTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour27715$0
View full utilization report →

Insurance plans in this area (ZIP 66502)

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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: 2769574748View full group profile
NameSpecialtyState
Clinical Social WorkerKS
Marriage And Family TherapistKS
Marriage And Family TherapistKS
Clinical Social WorkerKS

Reviews

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Frequently asked questions

What unique ID ties claims to KIMBERLY RAE SUDERMAN (LSCSW)?
NPI 1801353875 is assigned to KIMBERLY RAE SUDERMAN (LSCSW) under the national enumeration system.
Does this profile mean KIMBERLY RAE SUDERMAN (LSCSW) is currently active?
Yes — KIMBERLY RAE SUDERMAN (LSCSW) appears active in the national provider directory.
What does KIMBERLY RAE SUDERMAN (LSCSW) treat or focus on?
Patients typically see KIMBERLY RAE SUDERMAN (LSCSW) under the specialty Social Worker. Clinical services aligned with this taxonomy classification.
Where does public data place KIMBERLY RAE SUDERMAN (LSCSW)?
The snapshot lists Manhattan, Kansas for KIMBERLY RAE SUDERMAN (LSCSW); download NPPES for the complete set.
What if Manhattan, Kansas seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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