NICOLE SZUDY BUATALA (RN, MSN, FNP, PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1568985257
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,720 NURSE PRACTITIONER in MN
Provider Addresses for NICOLE SZUDY BUATALA (RN, MSN, FNP, PMHNP)
2103 COUNTY ROAD D E STE B
MAPLEWOOD, MN 551095358
Phone: (651) 748-5019
Fax: (651) 383-4529
Type: Location
St. Cloud VA Health Care System, 4801, Veterans Drive, St. Cloud, Stearns County, Minnesota, 56303, United States
SAINT CLOUD, MN 563032015
Phone: (218) 252-1670
Type: Location
202, 3rd Avenue Northeast, Brainerd, Crow Wing County, Minnesota, 56401, United States
BRAINERD, MN 564013146
Phone: (218) 851-5610
Type: Mailing
1100 BERGSLIEN ST
BALDWIN, WI 540022600
Phone: (715) 681-1111
Fax: (715) 684-1119
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: 2020-03-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20171107003224 | I | Nurse Practitioner | MN | TBD |
| I20200323000429 | I | Nurse Practitioner | WI | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55109)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MN | |
| Clinical Psychologist | AK | |
| Nurse Practitioner | MN | |
| Mental Health Counselor | MN | |
| Nurse Practitioner | MN | |
| Marriage And Family Therapist | MN | |
| Nurse Practitioner | MN | |
| Marriage And Family Therapist | MN | |
| Marriage And Family Therapist | MN | |
| Clinical Psychologist | MN |
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