SUSANNAH NICHOLSON DINTZIS (FNP) – Family Nurse Practitioner, NPI 1902848153
Family Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for SUSANNAH NICHOLSON DINTZIS (FNP)
800 W Romeo B Garrett Ave
Peoria, IL 616052207
Phone: (309) 676-9825
Fax: (309) 672-1518
Type: Location
2214, North University Street, Peoria, Peoria County, Illinois, 61604, United States
PEORIA, IL 616043221
Phone: (309) 680-7669
Fax: (309) 681-8443
Type: Mailing
2321, North Wisconsin Avenue, North Peoria, Peoria, Peoria County, Illinois, 61603, United States
PEORIA, IL 616035613
Phone: (309) 680-7600
Fax: (309) 681-4681
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 47 Open Payments records for all available years, with a total value of $1,001.
Total Amount is formed as General ($1,001) + Research ($0) + Ownership ($0) = $1,001.
Last reported payment date: 2024-12-02 • Largest payer in this snapshot: ABBVIE INC. ($239).
Total Amount
$1,001
General + Research + Ownership
Payments
47
Total payment records
General Amount
$1,001
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $239 |
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $142 |
| PFIZER INC. | $76 |
| Abbott Laboratories | $62 |
| ITI, Inc. | $56 |
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: 2016-01-29
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 |
|---|---|---|---|---|
| I20160129000098 | I | Nurse Practitioner | IL | 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 61605)
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