SUSAN K RETZLAFF DEITRICK (PA-C) – Physician Assistant, NPI 1912907981

SUSAN K RETZLAFF DEITRICK (PA-C) is a healthcare provider. based in Grand island, Nebraska. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 829 (NE). The NPI Number for SUSAN K RETZLAFF DEITRICK (PA-C) is 1912907981

Main info

Female
28 Years Of Experience
Accepts Medicare Assignment
Name
SUSAN K RETZLAFF DEITRICK (PA-C)
NPI
1912907981
Phone
(308) 384-9300
Address
PO BOX 5436
Enumeration Date
29 July 2005
Last Update Date
14 February 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3083849300
Graduation Year
1998 (28 years ago)
PAC ID
6507898574
Group Practice PAC ID
0244284768
Professional Enrollment ID
I20050910000056
Address ID
NE688034045GR418XXRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,396 PHYSICIAN ASSISTANT in NE

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Provider Addresses for SUSAN K RETZLAFF DEITRICK (PA-C)

  • PO box, Russell Road, Paoli, Tredyffrin Township, Chester County, Pennsylvania, 19301, United States

    GRAND ISLAND, NE 688025436

    Phone: (308) 384-9300

    Fax: (484) 359-8909

    Type: Mailing

  • 418, North Webb Road, Grand Island, Hall County, Nebraska, 68803, United States

    GRAND ISLAND, NE 688034045

    Phone: (308) 382-1100

    Fax: (308) 385-0796

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 143 Open Payments records for all available years, with a total value of $2,397.

Total Amount is formed as General ($2,397) + Research ($0) + Ownership ($0) = $2,397.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($1,030).

Total Amount

$2,397

General + Research + Ownership

Payments

143

Total payment records

General Amount

$2,397

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2005-09-10

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
I20050910000056IPhysician AssistantNETBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths1,577330$0
99213Established patient office or other outpatient visit, 20-29 minutes820664$0
17000Destruction of precancer skin growth, 1 growth545475$0
17110Destruction of skin growth, 1-14 growths395346$0
11102Biopsy of related skin growth, first growth215204$0
View full utilization report →

Insurance plans in this area (ZIP 68802)

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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: 0244284768View full group profile
NameSpecialtyState
Physician AssistantNE
D E R M A T O L O G YNE
Physician AssistantNE
Physician AssistantNE
Nurse PractitionerNE
Physician AssistantNE
P A T H O L O G YNE
D E R M A T O L O G YNE

Reviews

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Frequently asked questions

What unique ID ties claims to SUSAN K RETZLAFF DEITRICK (PA-C)?
NPI 1912907981 is assigned to SUSAN K RETZLAFF DEITRICK (PA-C) under the national enumeration system.
Is SUSAN K RETZLAFF DEITRICK (PA-C)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize SUSAN K RETZLAFF DEITRICK (PA-C)'s specialty in plain language?
Clinically, the directory lists SUSAN K RETZLAFF DEITRICK (PA-C) with Physician Assistant. Clinical services aligned with this taxonomy classification.
What location metadata exists for SUSAN K RETZLAFF DEITRICK (PA-C)?
The page summarizes Grand Island, Nebraska for SUSAN K RETZLAFF DEITRICK (PA-C); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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