SUSAN M HUMPHREYS (M.S.) – Specialist, NPI 1679519094
Specialist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
419 DERMATOLOGY in MN
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Provider Addresses for SUSAN M HUMPHREYS (M.S.)
7205, University Avenue Northeast, Fridley, Anoka County, Minnesota, 55432, United States
FRIDLEY, MN 554323134
Phone: (763) 571-4000
Fax: (763) 571-7202
Mailing address matches the actual address.
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: 2007-05-15
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 |
|---|---|---|---|---|
| I20070515000400 | I | Dermatology | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 15 | 15 | $0 |
Insurance plans in this area (ZIP 55432)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | MT | |
| - | ND | |
| Physician Assistant | MN | |
| Nurse Practitioner | SD | |
| - | MN | |
| Qualified Audiologist | MN | |
| - | MN | |
| - | MN | |
| P A T H O L O G Y | WV | |
| Family Practice | MN |
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