Kristen Deann Sutley, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

54996 Issued in MN

Practice address

2215 E Lake St FL 5
Minneapolis, MN 55407-4385

Phone

(612) 596-9438

NPI assigned

Apr 20, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hennepin CountyGroup PAC ID 7911892849, 132 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Hennepin County

  • Psychiatry Physician
  • Minneapolis, MN
  • NPI 1780790345
  Medicare reassignment Care Compare group NPD
• Hennepin County

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1962147413
  NPD

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1528384237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 E LAKE ST FL 5",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554074385",
            "telephone_number": "612-596-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 E LAKE ST FL 5",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554074385",
            "telephone_number": "612-596-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTLEY",
        "first_name": "KRISTEN",
        "middle_name": "DEANN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "54996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Jean Sussman, NP
• Sustainable Resources Center Inc
• Sustainable Resources Center, Inc.
• Thomas Mark Suszynski, MD, PHD
• Trudy Lynn Sutherland, LICSW
• Michael K Sutley, DDS
• Sutton Investments, LLP
• Jesse Daniel Sutton, PHARMD, BCIDP
• Makaila Sutton
• Nichol Marie Sutton, M.S.P.T.

• Psychiatry Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.