ASHA BALU SUDE – Dentist, NPI 1053833996

ASHA BALU SUDE is a healthcare provider. based in Mpls, Minnesota. specializing in DENTIST. They hold a License No. 00267 (NC). The NPI Number for ASHA BALU SUDE is 1053833996

Main info

Female
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
ASHA BALU SUDE
NPI
1053833996
Phone
(612) 626-0140
Address
515 DELAWARE ST SE
Enumeration Date
12 July 2017
Last Update Date
2 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2527377000
Graduation Year
2013 (13 years ago)
PAC ID
0648621532
Group Practice PAC ID
0244143246
Professional Enrollment ID
I20240104002476
Address ID
NC278345925GR1851XRDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:8State licenses:1Digital endpointsOther names

44 DENTIST in MN

Provider Addresses for ASHA BALU SUDE

  • 515 DELAWARE ST SE

    6-320 MOOS TOWER

    MPLS, MN 55455

    Phone: (612) 626-0140

    Type: Mailing

  • 515 DELAWARE ST

    6-440 MOOS TOWER

    MINNEAPOLIS, MN 554555545

    Phone: (612) 626-0140

    Fax: (612) 626-0140

    Type: Location

  • 1851 MACGREGOR DOWNS RD

    GREENVILLE, NC 278345925

    Phone: (252) 737-7000

    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: 2024-01-04

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
I20240104002476IDentistNCTBD

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 55455)

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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: 0244143246View full group profile
NameSpecialtyState
-NC
-NC
-NC
-VA
O B S T E T R I C S/ G Y N E C O L O G YNC
Nurse PractitionerNC
Diagnostic RadiologyNC
Nurse PractitionerNC
Pediatric MedicineNC
Nurse PractitionerNC

Reviews

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Frequently asked questions

Can I cross-check ASHA BALU SUDE using NPI 1053833996?
NPI 1053833996 belongs to ASHA BALU SUDE; compare other details if you need extra assurance.
Would ASHA BALU SUDE appear as active to a payer?
You can treat ASHA BALU SUDE as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for ASHA BALU SUDE?
At a glance, ASHA BALU SUDE is tied to Dentist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for ASHA BALU SUDE?
Travel planning: use Mpls, Minnesota as the reference point for ASHA BALU SUDE, then confirm.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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