MS. ELLEN MARIE SUNDSTROM (RN, FNP-BC) – Family Nurse Practitioner, NPI 1962688788
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,366 NURSE PRACTITIONER in OR
Provider Addresses for MS. ELLEN MARIE SUNDSTROM (RN, FNP-BC)
10011 BRIDGEPORT WAY SW SUITE 1500 PMB 201
LAKEWOOD, WA 98499
Phone: (214) 686-3588
Type: Mailing
82911 BEACH ACCESS RD
UMATILLA, OR 978829419
Phone: (214) 686-3588
Type: Location
8500 Village Dr Ste 101
San Antonio, TX 782175510
Phone: (726) 201-3047
Fax: (833) 629-0318
Type: Location
ELEANOR HEALTH SEATTLE CLINIC
1120 E TERRACE STREET SUITE 100
SEATTLE, WA 981227405
Phone: (206) 594-1065
Fax: (833) 654-0691
Type: Location
SNOHOMISH COUNTY JAIL
3025 OAKES AVE
EVERETT, WA 98201
Phone: (425) 388-3395
Fax: (425) 388-3526
Type: Location
10011 BRIDGEPORT WAY SE SUITE 1500 PMB 201
LAKEWOOD, WA 984992332
Phone: (214) 686-3588
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $33.
Total Amount is formed as General ($33) + Research ($0) + Ownership ($0) = $33.
Last reported payment date: 2024-06-12 • Largest payer in this snapshot: ViiV Healthcare Company ($33).
Total Amount
$33
General + Research + Ownership
Payments
1
Total payment records
General Amount
$33
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ViiV Healthcare Company | $33 |
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: 2025-01-07
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 |
|---|---|---|---|---|
| I20080612000344 | I | Nurse Practitioner | TX | TBD |
| I20181115002607 | I | Nurse Practitioner | WA | TBD |
| I20241224001442 | I | Nurse Practitioner | MA | TBD |
| I20250107003762 | I | Nurse Practitioner | NJ | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98499)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX | |
| Nurse Practitioner | WA | |
| Addiction Medicine, Psychiatry, Psychiatry, Addiction Medicine | NC | |
| Mental Health Counselor | WA |
Reviews
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