SUSAN ANN ADDIE (N.P.) – Nurse Practitioner, NPI 1083596118

SUSAN ANN ADDIE (N.P.) is a healthcare provider. based in Tyler, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials N.P.. They hold a License No. 1206581 (TX). The NPI Number for SUSAN ANN ADDIE (N.P.) is 1083596118

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
SUSAN ANN ADDIE (N.P.)
NPI
1083596118
Phone
(903) 596-3604
Address
700 OLYMPIC PLAZA CIR STE 850
Enumeration Date
21 July 2025
Last Update Date
21 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2024 (2 years ago)
PAC ID
1456851369
Group Practice PAC ID
9739159682
Professional Enrollment ID
I20250825003247
Address ID
TX756525956HE300XXSTXX303
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for SUSAN ANN ADDIE (N.P.)

  • 700 OLYMPIC PLAZA CIR STE 850

    TYLER, TX 757011955

    Phone: (903) 596-3604

    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: 2025-08-25

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
I20250825003247INurse PractitionerTXTBD

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 75701)

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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: 9739159682View full group profile
NameSpecialtyState
Nurse PractitionerTX
Nurse PractitionerTX
O B S T E T R I C S/ G Y N E C O L O G YTX
Family Practice, Emergency MedicineTX
Nurse PractitionerAR
Addiction MedicineTX
Family PracticeTX
Family Practice, General PracticeTX
O B S T E T R I C S/ G Y N E C O L O G YTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

How do payers reference SUSAN ANN ADDIE (N.P.)?
For SUSAN ANN ADDIE (N.P.), use NPI 1083596118 as the unique 10-digit identifier.
Is SUSAN ANN ADDIE (N.P.) shown as active in public data?
Registry records indicate SUSAN ANN ADDIE (N.P.) maintains an active NPI.
What expertise is attributed to SUSAN ANN ADDIE (N.P.)?
SUSAN ANN ADDIE (N.P.)'s specialty line reads Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is SUSAN ANN ADDIE (N.P.) located near Tyler?
SUSAN ANN ADDIE (N.P.) currently maps to Tyler, Texas in this extract.
When was this NPI issued?
Enumeration for SUSAN ANN ADDIE (N.P.) is noted as July 21, 2025 where the registry provides it.

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