MRS. MARY SUSAN CLIPP CPNP-AC
NPI 1003150194
Nurse Practitioner - Pediatrics, Critical Care in Minneapolis, MN
About Mrs. Mary Susan Clipp Cpnp-ac NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. MARY SUSAN CLIPP CPNP-AC (NPI 1003150194) is an individual pediatrics, critical care provider in Minneapolis, Minnesota, licensed in Minnesota (2036438) and active in the NPI registry since November 2012. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Mary Susan Clipp Cpnp-ac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mary Clipp reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Round Rock, TX 78681
- Reassigned Medicare billing, Texas enrollment
- Medicare enrollment name: Dell Childrens Medical Group
- 576 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55454 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MINNEAPOLIS, MN 55454
MINNEAPOLIS, MN 55454
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mary Clipp's NPI number?
The NPI number for Mary Clipp is 1003150194. It was assigned to this individual provider in the NPPES registry on November 15, 2012.
Where is Mary Clipp located?
Mary Clipp practices at 2450 Riverside Ave, Minneapolis, MN 55454. The listed phone number is (612) 365-3100.
What is Mary Clipp's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, Critical Care, with taxonomy code 363LP0222X.
Is Mary Clipp enrolled in Medicare?
Yes. Mary Clipp is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mary Clipp's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Clipp reassigns Medicare benefits to Dell Children's Medical Group (Round Rock, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Clipp's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mary Clipp accept?
Health plans from Blue Cross and Blue Shield of Texas, Harbor Health, Moda Health Plan, Inc., Oscar Insurance Company and Sendero Health Plans, Local Nonprofit list Mary Clipp as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mary Clipp was last updated on November 15, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Mary Susan Clipp, CPNP-AC · NPI 1003150194
Pediatrics, Critical Care physician in Minneapolis, Minnesota. Individual provider, active in the CMS NPPES registry since November 15, 2012.
## Identity
- **NPI:** 1003150194 (Entity type: Individual)
- **Enumerated:** November 15, 2012
- **Primary specialty:** Nurse Practitioner - Pediatrics, Critical Care · taxonomy 363LP0222X
- **State license:** 2036438 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 2450 RIVERSIDE AVE, Minneapolis, MN 55454-1450
- **Phone:** (612) 365-3100 · **Fax:** (612) 365-3110
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Dell Children's Medical Group (NPI 1790103869, Round Rock, TX), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 15, 2012
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Source: [NPI Profile](https://npiprofile.com/npi/1003150194) · Data from the CMS NPPES public registry.