DR. MARK ELMER SUNDBY (PH.D.) – Counseling Psychologist, NPI 1710278502

DR. MARK ELMER SUNDBY (PH.D.) is a healthcare provider. based in New brighton, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. LP4114 (MN). The NPI Number for DR. MARK ELMER SUNDBY (PH.D.) is 1710278502

Main info

Male
Sole Proprietor
29 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARK ELMER SUNDBY (PH.D.)
NPI
1710278502
Phone
(651) 636-5120
Address
516 MISSION HOUSE LN
Enumeration Date
27 April 2011
Last Update Date
27 April 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6516365120
Graduation Year
1997 (29 years ago)
PAC ID
3577793272
Group Practice PAC ID
7214346345
Professional Enrollment ID
I20140225001177
Address ID
MN551122571NE516XXLNXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

Provider Addresses for DR. MARK ELMER SUNDBY (PH.D.)

  • 516 MISSION HOUSE LN

    NEW BRIGHTON, MN 551122571

    Phone: (651) 636-5120

    Fax: (651) 636-5124

    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: 2014-02-25

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
I20140225001177IClinical 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 55112)

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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: 7214346345View full group profile
NameSpecialtyState
Marriage And Family TherapistMN
Clinical PsychologistMN
Mental Health CounselorMN
Clinical PsychologistMN
Marriage And Family TherapistMN
Clinical PsychologistMN
Mental Health CounselorMN

Reviews

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Frequently asked questions

What is the registry number for DR. MARK ELMER SUNDBY (PH.D.)?
The registry entry for DR. MARK ELMER SUNDBY (PH.D.) shows NPI 1710278502.
Is DR. MARK ELMER SUNDBY (PH.D.)'s NPI status active today?
Active status means DR. MARK ELMER SUNDBY (PH.D.)'s NPI record is not deactivated in the public file.
What type of care does DR. MARK ELMER SUNDBY (PH.D.) provide?
DR. MARK ELMER SUNDBY (PH.D.)'s profile centers on Counseling Psychologist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. MARK ELMER SUNDBY (PH.D.)?
DR. MARK ELMER SUNDBY (PH.D.) is associated with New Brighton, Minnesota in the same public data insurers reference.
Who maintains DR. MARK ELMER SUNDBY (PH.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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