SEAN PRUETT (CRNA) – Certified Registered Nurse Anesthetist, NPI 1679310122

SEAN PRUETT (CRNA) is a healthcare provider. based in Elmendorf afb, Alaska. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 225541 (AK). The NPI Number for SEAN PRUETT (CRNA) is 1679310122

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
SEAN PRUETT (CRNA)
NPI
1679310122
Phone
(907) 580-5630
Address
5955 ZEAMER AVE
Enumeration Date
11 July 2024
Last Update Date
15 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9076774752
Graduation Year
2024 (2 years ago)
PAC ID
9436671484
Group Practice PAC ID
2961465653
Professional Enrollment ID
I20250319001122
Address ID
AK995085234AN3801XPKWY401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

133 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in AK

Provider Addresses for SEAN PRUETT (CRNA)

  • 5955 ZEAMER AVE

    ELMENDORF AFB, AK 995063702

    Phone: (907) 580-5630

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250319001122ICertified Registered Nurse Anesthetist (Crna)AKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 99506)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2961465653View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)AK
A N E S T H E S I O L O G YAK
Anesthesiology, Interventional Pain ManagementNM
A N E S T H E S I O L O G YAK
A N E S T H E S I O L O G YUT
Certified Registered Nurse Anesthetist (Crna)AK
Certified Registered Nurse Anesthetist (Crna)CO
A N E S T H E S I O L O G YAK
Certified Registered Nurse Anesthetist (Crna)AK
Certified Registered Nurse Anesthetist (Crna)AK

Reviews

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Frequently asked questions

What federal number belongs to SEAN PRUETT (CRNA)?
The federal identifier for SEAN PRUETT (CRNA) is NPI 1679310122.
Is SEAN PRUETT (CRNA) currently active in the NPI registry?
CMS-published data lists SEAN PRUETT (CRNA) as an active registrant.
What kind of provider is SEAN PRUETT (CRNA)?
The page reflects Certified Registered Nurse Anesthetist for SEAN PRUETT (CRNA). Clinical services aligned with this taxonomy classification.
What location metadata exists for SEAN PRUETT (CRNA)?
The page summarizes Elmendorf Afb, Alaska for SEAN PRUETT (CRNA); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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