SUSAN SANDOVAL (M.D.) – Pediatrics Physician, NPI 1740286277
Pediatrics Physician
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for SUSAN SANDOVAL (M.D.)
Lakeland Regional Health Medical Center, 1324, Lakeland Hills Boulevard, Lakeland, Polk County, Florida, 33805, United States
MEDICAL STAFF OFFICE
LAKELAND, FL 338054543
Phone:
Type: Mailing
430, East Central Avenue, Winter Haven, Polk County, Florida, 33880, United States
WINTER HAVEN, FL 338803050
Phone: (863) 284-6850
Fax: (863) 284-6853
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $100.
Total Amount is formed as General ($100) + Research ($0) + Ownership ($0) = $100.
Last reported payment date: 2023-05-10 • Largest payer in this snapshot: Ironshore Pharmaceuticals Inc. ($24).
Total Amount
$100
General + Research + Ownership
Payments
5
Total payment records
General Amount
$100
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-10
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2013-08-13
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 |
|---|---|---|---|---|
| I20130813000652 | I | Pediatric Medicine | FL | 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 33805)
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