NPIMap

Individual provider Active NPI

Susan K Cariveau, NP

  • Nurse Practitioner
  • Detroit Lakes, MN
National Provider Identifier
1023115805
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R21145 Issued in ND
Practice address
1245 Washington Ave
Detroit Lakes, MN 56501-3905
Phone
(218) 846-2000
NPI assigned
Sep 20, 2006
Last updated
Jun 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R21145 ND Primary
Family Nurse Practitioner 363LF0000X 2953 MN

Addresses

Primary practice location

1245 Washington Ave
Detroit Lakes, MN 56501-3905

Mailing address

1245 Washington Ave
Detroit Lakes, MN 56501-3905
Phone (218) 846-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130507000500 MN Practitioner - Nurse Practitioner 1951370543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Dakota School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians
Sanford Clinic NorthGroup PAC ID 4284546151, 9 clinicians

Practice addresses (Care Compare)

1245 Washington Ave
Detroit Lakes, MN 56501-3905
Phone (218) 846-2000

1412 Main St
Hawley, MN 56549
Phone (218) 483-3564

410 4TH St NW
Mahnomen, MN 56557-4208
Phone (218) 935-2514

410 4TH St SW
Mahnomen, MN 56557-4732
Phone (218) 835-2514

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R21145NDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Aug 27, 2014 Accepting new patients
Sanford Medical Center Fargo CurrentSince Aug 27, 2014 Accepting new patients

Locations

1245 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 846-2000

410 4th St SW
Mahnomen, MN 56557
Phone (218) 835-2514

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

1000 Coney St W
Perham, MN 56573
Phone (218) 347-1200

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1023115805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 WASHINGTON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013905",
            "telephone_number": "218-846-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WASHINGTON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013905",
            "telephone_number": "218-846-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARIVEAU",
        "first_name": "SUSAN",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R21145",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "2953",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit Lakes, MN

Sources for this page

Verify at the official NPI Registry.