DR. BRIAN DIEVENDORF SUSI (MD) – Cardiovascular Disease Physician, NPI 1922079862

DR. BRIAN DIEVENDORF SUSI (MD) is a healthcare provider. based in Union city, New Jersey. specializing in Cardiovascular Disease Physician. They hold the professional credentials MD. They hold a License No. 25MA09314200 (NJ). The NPI Number for DR. BRIAN DIEVENDORF SUSI (MD) is 1922079862

Main info

Male
Sole Proprietor
Name
DR. BRIAN DIEVENDORF SUSI (MD)
NPI
1922079862
Phone
(917) 232-2458
Address
209 MANHATTAN AVE
Enumeration Date
30 January 2006
Last Update Date
14 January 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for DR. BRIAN DIEVENDORF SUSI (MD)

  • 209 MANHATTAN AVE

    APC C

    UNION CITY, NJ 070875204

    Phone: (917) 232-2458

    Type: Mailing

  • 411, Jefferson Street, Hoboken, Hudson County, New Jersey, 07030, United States

    UNIT 2

    HOBOKEN, NJ 070302606

    Phone: (917) 232-2458

    Type: Mailing

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: 2017-09-21

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
I20170921000365ICardiovascular Disease (Cardiology)NJTBD

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 07087)

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Reviews

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Frequently asked questions

Where can patients find DR. BRIAN DIEVENDORF SUSI (MD)'s NPI?
You can confirm DR. BRIAN DIEVENDORF SUSI (MD) with NPI 1922079862; it appears in the national provider directory.
Is DR. BRIAN DIEVENDORF SUSI (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is DR. BRIAN DIEVENDORF SUSI (MD)?
The page reflects Cardiovascular Disease Physician for DR. BRIAN DIEVENDORF SUSI (MD). Clinical services aligned with this taxonomy classification.
Where is DR. BRIAN DIEVENDORF SUSI (MD)'s primary listing?
We display Union City, New Jersey because that is what the record indicates for DR. BRIAN DIEVENDORF SUSI (MD).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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