SUSAN PAYNE ETHERIDGE (MD) – Clinical Cardiac Electrophysiology Physician, NPI 1952480527
Clinical Cardiac Electrophysiology Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
25 CARDIAC ELECTROPHYSIOLOGY in ID
Provider Addresses for SUSAN PAYNE ETHERIDGE (MD)
PO BOX 413021
SALT LAKE CITY, UT 841413021
Phone: (801) 213-3900
Fax: (801) 585-3655
Type: Mailing
305 E Jefferson St
Boise, ID 837126231
Phone: (208) 381-7370
Fax: (208) 381-7387
Type: Location
81 N Mario Capecchi Dr
Salt Lake City, UT 841131125
Phone: (801) 213-3599
Fax: (801) 213-7778
Type: Location
Mario Capecchi Drive, Salt Lake City, Salt Lake County, Utah, 84412, United States
SALT LAKE CITY, UT 841131125
Phone: (801) 213-3599
Fax: (801) 213-7778
Type: Location
725 WELCH RD
PALO ALTO, CA 943041601
Phone: (650) 497-8000
Type: Mailing
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 $225.
Total Amount is formed as General ($225) + Research ($0) + Ownership ($0) = $225.
Last reported payment date: 2024-11-15 • Largest payer in this snapshot: Abbott Laboratories ($122).
Total Amount
$225
General + Research + Ownership
Payments
6
Total payment records
General Amount
$225
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $122 |
| Philips North America LLC | $63 |
| ACADIA Pharmaceuticals Inc | $23 |
| AltaThera Pharmaceuticals LLC | $16 |
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: 2025-04-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20040205000287 | I | Pediatric Medicine | UT | TBD |
| I20141002002519 | I | Pediatric Medicine | AK | TBD |
| I20240524002311 | I | Pediatric Medicine | CA | TBD |
| I20250422003398 | I | Cardiac Electrophysiology | ID | 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 |
|---|---|---|---|---|
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 23 | 13 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 16 | 11 | $0 |
Insurance plans in this area (ZIP 84141)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AK | |
| Nurse Practitioner | WA | |
| - | AK | |
| Cardiovascular Disease (Cardiology), Internal Medicine, Interventional Cardiology | AK | |
| Nurse Practitioner | AK | |
| Cardiac Electrophysiology, Cardiovascular Disease (Cardiology) | AK | |
| Nurse Practitioner | AK | |
| Cardiovascular Disease (Cardiology) | AK | |
| Nurse Practitioner | AK | |
| - | AK |
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