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JACLYN ROSE SUCHY
NPI 1114717543
Counselor - Professional in Shoreview, MN

Active since May 08, 2025PECOS EnrolledAccepts Medicare Assignment
3490 LEXINGTON AVE N STE 205, SHOREVIEW, MN 55126(651) 486-3808 Get Directions Write a Review

NPPES record last updated: May 8, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jaclyn Rose Suchy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACLYN ROSE SUCHY (NPI 1114717543) is an individual professional provider in Shoreview, Minnesota, licensed in Minnesota (4950) and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1114717543
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameJACLYN ROSE SUCHY
Location Address3490 LEXINGTON AVE N STE 205Shoreview, MN 55126-8044
Mailing Address240 Robert DrHastings, MN 55033-8807 · (651) 428-4423
Phone(651) 486-3808
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMay 8, 2025
NPPES CertifiedMay 8, 2025
✔ NPI 1114717543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MN · 4950
3490 LEXINGTON AVE N STE 205, Shoreview, MN 55126
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jaclyn Rose Suchy is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173018462
PECOS Enrollment IDI20251224000275
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jaclyn Suchy reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Introspect Mental Health LLC
7.2 mi
Mental Health
4801 HIGHWAY 61 N STE 204
White Bear Lk, MN 55110
  • Reassigned Medicare billing, Minnesota enrollment
  • 8 clinicians in this Medicare group
NPI 1184273666 (763) 465-6700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JILL MARIE BUCKINGHAM DTR, LICSW
Social Worker (Clinical)
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
VICKI LYNN SCHROEDER LICSW
Social Worker
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
VANESSA ANN SHUCK MSW, LGSW
Social Worker
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
TRISHA LYNN LORRAINE SARGENT LICSW
Social Worker (Clinical)
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 379-3414
MISS CARLA KAHALE ANTON LMFT
Marriage & Family Therapist
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
MS. LUCILLE AMIS-ROSARIO MSW, LICSW
Social Worker (Clinical)
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
SAMANTHA ROSE LUECK MSW, LGSW
Social Worker (Clinical)
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 379-3429
CAROLYN MARIE BABEKUHL MSW, LICSW
Social Worker (Clinical)
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808

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 Jaclyn Suchy's NPI number?

The NPI number for Jaclyn Suchy is 1114717543. It was assigned to this individual provider in the NPPES registry on May 8, 2025.

Where is Jaclyn Suchy located?

Jaclyn Suchy practices at 3490 Lexington Ave N Ste 205, Shoreview, MN 55126. The listed phone number is (651) 486-3808.

What is Jaclyn Suchy's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Jaclyn Suchy enrolled in Medicare?

Yes. Jaclyn Suchy is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jaclyn Suchy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jaclyn Suchy reassigns Medicare benefits to Introspect Mental Health LLC (White Bear Lk, MN). 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 Jaclyn Suchy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jaclyn Suchy accept?

Health plans from HealthPartners list Jaclyn Suchy 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 Jaclyn Suchy was last updated on May 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.