AMBROSE K SU (DPM) – Foot Surgery Podiatrist, NPI 1588649297
Foot Surgery Podiatrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
213 PODIATRY in OR
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Provider Addresses for AMBROSE K SU (DPM)
Division Street, Bend, Deschutes County, Oregon, 97703, United States
BEND, OR 977013543
Phone: (541) 388-2861
Fax: (541) 382-6297
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)
CMS reports 6 Open Payments records for all available years, with a total value of $206.
Total Amount is formed as General ($206) + Research ($0) + Ownership ($0) = $206.
Last reported payment date: 2024-11-06 • Largest payer in this snapshot: Access Pro Medical, LLC ($156).
Total Amount
$206
General + Research + Ownership
Payments
6
Total payment records
General Amount
$206
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Access Pro Medical, LLC | $156 |
| Steelhead Surgical Inc | $27 |
| MIMEDX Group, Inc. | $23 |
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: 2011-02-22
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 |
|---|---|---|---|---|
| I20110222001182 | I | Podiatry | OR | 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 |
|---|---|---|---|---|
| 76881 | Complete ultrasound scan of joint | 1,176 | 164 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1,088 | 259 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 487 | 186 | $0 |
| 11721 | Removal of fingernails or toenails, 6 or more nails | 480 | 162 | $0 |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 328 | 56 | $0 |
Insurance plans in this area (ZIP 97701)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PODIATRY | OR | 11056 | Removal of 2 to 4 thickened skin growths | 13 | 12 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CA |
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