MR. JERRY EDWARD GLATTFELT (CRNA) – Certified Registered Nurse Anesthetist, NPI 1073594461
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MR. JERRY EDWARD GLATTFELT (CRNA)
1131, Park Lane, Suisun City, Solano County, California, 94585, United States
SUISUN CITY, CA 945852878
Phone: (707) 428-4272
Type: Mailing
100 BODIN CIR
60 TH MSGS/SGCSA
TRAVIS AFB, CA 945351804
Phone: (707) 423-5370
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: 2016-09-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20081029000491 | I | Certified Registered Nurse Anesthetist (Crna) | FL | TBD |
| I20160907000742 | I | Certified Registered Nurse Anesthetist (Crna) | CO | TBD |
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.
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 94585)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| CERTIFIED REGISTERED NURSE ANESTHET | CA | 01402 | Anesthesia for open or endoscopic total knee joint replacement | 23 | 23 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| - | MO | |
| Certified Registered Nurse Anesthetist (Crna) | CO | |
| Certified Registered Nurse Anesthetist (Crna) | CO | |
| Certified Registered Nurse Anesthetist (Crna) | NC | |
| Certified Registered Nurse Anesthetist (Crna) | MS | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| - | MO | |
| Certified Registered Nurse Anesthetist (Crna) | CO | |
| Certified Registered Nurse Anesthetist (Crna) | WA |
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