DR. SUZANNE A MOSELEY (PHD) – Clinical Neuropsychologist, NPI 1053936922

DR. SUZANNE A MOSELEY (PHD) is a healthcare provider. based in Roseville, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 6551 (MN). The NPI Number for DR. SUZANNE A MOSELEY (PHD) is 1053936922

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
DR. SUZANNE A MOSELEY (PHD)
NPI
1053936922
Phone
(651) 241-5290
Address
2720 FAIRVIEW AVE N STE 100
Enumeration Date
16 June 2020
Last Update Date
14 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6512415290
Graduation Year
2013 (13 years ago)
PAC ID
2668898818
Group Practice PAC ID
6709771363
Professional Enrollment ID
I20200818002907
Address ID
MN551131306RO2720XNXXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

Provider Addresses for DR. SUZANNE A MOSELEY (PHD)

  • 2720 FAIRVIEW AVE N STE 100

    ROSEVILLE, MN 551131306

    Phone: (651) 241-5290

    Type: Mailing

  • 1356 HEWITT AVE

    SAINT PAUL, MN 551041305

    Phone: (760) 522-1484

    Type: Mailing

  • 225 SMITH AVE N

    SAINT PAUL, MN 551022533

    Phone: (651) 241-5304

    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: 2020-08-18

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
I20200818002907IClinical PsychologistMNTBD

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 55113)

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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: 6709771363View full group profile
NameSpecialtyState
N E U R O L O G YMN
Physician AssistantMN
-MN
Physician AssistantMN
Clinical PsychologistMN
Nurse PractitionerMN
N E U R O L O G YMN
Physician AssistantMN
N E U R O L O G YMN
N E U R O L O G YMN

Reviews

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Frequently asked questions

What is DR. SUZANNE A MOSELEY (PHD)'s NPI number?
DR. SUZANNE A MOSELEY (PHD)'s NPI is 1053936922 — the number used across U.S. healthcare to identify this provider.
Is there an active status for DR. SUZANNE A MOSELEY (PHD)?
For scheduling context, DR. SUZANNE A MOSELEY (PHD) is shown as active in the registry.
How would a patient describe DR. SUZANNE A MOSELEY (PHD)'s focus?
For DR. SUZANNE A MOSELEY (PHD), the primary taxonomy reads as Clinical Neuropsychologist. Clinical services aligned with this taxonomy classification.
Where in Minnesota is DR. SUZANNE A MOSELEY (PHD) registered?
Use Roseville, Minnesota as the headline location for DR. SUZANNE A MOSELEY (PHD) here.
When was this NPI issued?
Enumeration for DR. SUZANNE A MOSELEY (PHD) is noted as June 16, 2020 where the registry provides it.

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