SUSAN E KELLOGG (PA) – Physician Assistant, NPI 1154301091

SUSAN E KELLOGG (PA) is a healthcare provider. based in Westborough, Massachusetts. specializing in Physician Assistant. They hold the professional credentials PA. They hold a License No. 275 (MA). The NPI Number for SUSAN E KELLOGG (PA) is 1154301091

Main info

Female
50 Years Of Experience
Accepts Medicare Assignment
Name
SUSAN E KELLOGG (PA)
NPI
1154301091
Phone
(508) 871-0700
Address
106 E Main St
Enumeration Date
18 January 2006
Last Update Date
9 March 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9785346500
Graduation Year
1976 (50 years ago)
PAC ID
3577512672
Group Practice PAC ID
5597755322
Professional Enrollment ID
I20050114000832
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for SUSAN E KELLOGG (PA)

  • 106 E Main St

    Westborough, MA 015811417

    Phone: (508) 871-0700

    Fax: (508) 616-4411

    Type: Location

  • Plantation Street, Worcester, Worcester County, Massachusetts, 01653, United States

    WORCESTER, MA 016052038

    Phone: (508) 871-0700

    Fax: (508) 616-4411

    Type: Mailing

  • 700;900, Union Street, Baystate Commons, Westborough, Worcester County, Massachusetts, 01581, United States

    WESTBOROUGH, MA 015815408

    Phone: (508) 871-0700

    Fax: (508) 616-4411

    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: 2005-01-14

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
I20050114000832IPhysician AssistantMATBD

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 01581)

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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: 5597755322View full group profile
NameSpecialtyState
D E R M A T O L O G YMA
Internal MedicineMA
-MA
-MA
Emergency MedicineMA
Physical Therapist In Private PracticeMA
Physician AssistantMA
Family PracticeMA
Clinical PsychologistMA
-MA

Reviews

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Frequently asked questions

Where can patients find SUSAN E KELLOGG (PA)'s NPI?
You can confirm SUSAN E KELLOGG (PA) with NPI 1154301091; it appears in the national provider directory.
Is SUSAN E KELLOGG (PA) active in the national directory?
SUSAN E KELLOGG (PA)'s public NPI profile is in an active state.
Does SUSAN E KELLOGG (PA) list a primary specialty?
If you are matching referrals, note Physician Assistant for SUSAN E KELLOGG (PA). Clinical services aligned with this taxonomy classification.
Where is SUSAN E KELLOGG (PA)'s primary listing?
We display Westborough, Massachusetts because that is what the record indicates for SUSAN E KELLOGG (PA).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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