DR. THEODORE SURDY (PHD LP) – Clinical Psychologist, NPI 1063463347
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. THEODORE SURDY (PHD LP)
16200 560TH LN
GOOD THUNDER, MN 560372199
Phone:
Type: Mailing
Surdy Psychological Services, 1207, Caledonia Street, Mankato, Blue Earth County, Minnesota, 56001, United States
MANKATO, MN 560014329
Phone: (507) 388-8874
Fax: (507) 388-8874
Type: Location
1227 CALEDONIA ST
MANKATO, MN 560014329
Phone: (507) 388-8874
Fax: (507) 685-4807
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.
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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: 2007-05-03
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 |
|---|---|---|---|---|
| I20070503000476 | I | Clinical Psychologist | MN | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 96139 | Administration of psychological or neuropsychological test by technician, each additional 30 minutes | 185 | 15 | $0 |
| 90834 | Psychotherapy, 45 minutes | 178 | 21 | $0 |
| 96133 | Evaluation of neuropsychological test, each additional hour | 70 | 14 | $0 |
| 90837 | Psychotherapy, 1 hour | 47 | 14 | $0 |
| 96138 | Administration of psychological or neuropsychological test by technician, first 30 minutes | 39 | 15 | $0 |
Insurance plans in this area (ZIP 56037)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHOLOGIST, CLINICAL | MN | 96118 | Neuropsychological testing, interpretation, and report by psychologist or physician per hour | 121 | 15 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | MN | |
| Mental Health Counselor | MN |
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