KELTON CREST MERRILL – Certified Registered Nurse Anesthetist, NPI 1043098494

KELTON CREST MERRILL is a healthcare provider. based in Glendale, Arizona. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. RN208298 (AZ). The NPI Number for KELTON CREST MERRILL is 1043098494

Main info

Male
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
KELTON CREST MERRILL
NPI
1043098494
Phone
(928) 245-5056
Address
18853 N 59TH DR
Enumeration Date
18 September 2023
Last Update Date
22 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9283484000
Graduation Year
2023 (3 years ago)
PAC ID
3971958729
Group Practice PAC ID
6204822364
Professional Enrollment ID
I20231013001180
Address ID
AZ855464011SA1600XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:2State licenses:2Digital endpointsOther names

1,061 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in AZ

Provider Addresses for KELTON CREST MERRILL

  • 18853 N 59TH DR

    GLENDALE, AZ 853087604

    Phone: (928) 245-5056

    Type: Mailing

  • 10401 W THUNDERBIRD BLVD

    SUN CITY, AZ 853513004

    Phone: (623) 832-4000

    Type: Location

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: 2023-10-13

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
I20231013001180ICertified Registered Nurse Anesthetist (Crna)AZTBD

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 85308)

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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: 6204822364View full group profile
NameSpecialtyState
General SurgeryAZ
Diagnostic RadiologyAZ
Internal Medicine, Hospitalist, Internal MedicineAZ
Certified Registered Nurse Anesthetist (Crna)AZ
Orthopedic Surgery, Sports MedicineAZ
Diagnostic RadiologyTX
Internal MedicineTN
Diagnostic RadiologyFL
Certified Registered Nurse Anesthetist (Crna)AZ
-AZ

Reviews

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Frequently asked questions

How do I look up KELTON CREST MERRILL by NPI?
Use NPI 1043098494 when you need to reference KELTON CREST MERRILL in forms, claims, or directories.
Does this profile mean KELTON CREST MERRILL is currently active?
Yes — KELTON CREST MERRILL appears active in the national provider directory.
What kind of provider is KELTON CREST MERRILL?
The page reflects Certified Registered Nurse Anesthetist for KELTON CREST MERRILL. Clinical services aligned with this taxonomy classification.
What location shows for KELTON CREST MERRILL?
We surface Glendale, Arizona for KELTON CREST MERRILL based on available NPPES addresses.
What if Glendale, Arizona seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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