Kenny Susanto, MD
NPI 1255783270ActiveIndividual· Psychiatry & Neurology, Neurology· Tulsa, OK
Psychiatry & Neurology, Neurology (MD) with St. John Physicians, Inc., practicing in Tulsa, Oklahoma. Their prescriptions cost Medicare Part D more than their services did: $492,904 for 1,109 claims, against $114,310 paid for services in 2024. Medtronic, Inc. reported $1,925 in payments in 2024, mostly travel and lodging. Lists Ascension St John Broken Arrow and 4 other hospitals as hospital affiliations.
Overview
| NPI | 1255783270 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | No |
| NPI issued | Jul 2, 2016 |
| Last updated in NPPES | Jun 27, 2022 |
| Certified by provider | Jul 30, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychiatry & Neurology, Neurology Primary | 2084N0400X | 38794 | OK |
| Psychiatry & Neurology, Neurology | 2084N0400X | 1.065004 | CT |
| Psychiatry & Neurology, Neurology | 2084N0400X | 008863 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Neurology (OK) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 254 |
|---|---|
| Services billed | 9,850 across 35 procedure codes |
| Paid by Medicare | $114,310 |
Part D prescriptions in 2024
| Prescriptions (claims) | 1,109 · 1,788 30-day fills |
|---|---|
| Patients | 191 |
| Total drug cost | $492,904 |
| Generic share | 86% of claims |
Education and affiliations
| Graduation year | 2012 |
|---|---|
| Medicare specialty | Neurology |
| Telehealth | Offers telehealth |
Medical group
- St. John Physicians, Inc.Tulsa, OK · 259 clinicians
Hospital affiliations
- Ascension St John Broken ArrowBroken Arrow, OK
- Ascension St John Jane PhillipsBartlesville, OK
- Ascension St John Medical CenterTulsa, OK
- Integris Southwest Medical CenterOklahoma City, OK
- St John OwassoOwasso, OK
Industry payments (Open Payments)
- 2024$1,925 · 14 payments from 1 company
Top paying companies in 2024
| Company | Amount | Payments |
|---|---|---|
| Medtronic, Inc. | $1,925 | 14 |
What the 2024 payments were for
- Travel and Lodging$1,526 · 8 payments
- Food and Beverage$398.69 · 6 payments
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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