DEANA MARIE FANTOM (CRNA) – Certified Registered Nurse Anesthetist, NPI 1285930339
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
801 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in CO
Provider Addresses for DEANA MARIE FANTOM (CRNA)
400 W 16th St
Pueblo, CO 810032745
Phone: (719) 584-2722
Fax: (719) 584-1439
Type: Location
8000 E MAPLEWOOD AVE
STE 200
GREENWOOD VILLAGE, CO 801114727
Phone: (719) 537-0712
Fax: (719) 537-6284
Type: Mailing
PO BOX 176221
DENVER, CO 802176221
Phone: (303) 629-2297
Type: Location
PO BOX 840862
DALLAS, TX 752840862
Phone: (303) 377-7638
Fax: (303) 780-0787
Type: Mailing
8000 E MAPLEWOOD AVE STE 200
GREENWOOD VILLAGE, CO 801114727
Phone: (303) 438-3999
Fax: (720) 439-9500
Type: Location
11600 W 2nd Pl
Lakewood, CO 802281527
Phone: (720) 321-1010
Fax: (720) 321-1001
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $38.
Total Amount is formed as General ($38) + Research ($0) + Ownership ($0) = $38.
Last reported payment date: 2024-06-12 • Largest payer in this snapshot: QOL Medical, LLC ($38).
Total Amount
$38
General + Research + Ownership
Payments
2
Total payment records
General Amount
$38
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| QOL Medical, LLC | $38 |
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: 2011-08-09
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110809000018 | 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 81003)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| CERTIFIED REGISTERED NURSE ANESTHET | CO | 00142 | Anesthesia for lens surgery | 12 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | CO | |
| Certified Registered Nurse Anesthetist (Crna) | NE | |
| Certified Registered Nurse Anesthetist (Crna) | CO | |
| Certified Registered Nurse Anesthetist (Crna) | CO | |
| Certified Registered Nurse Anesthetist (Crna) | OH | |
| A N E S T H E S I O L O G Y | CO | |
| A N E S T H E S I O L O G Y | CO | |
| Certified Registered Nurse Anesthetist (Crna) | CO | |
| A N E S T H E S I O L O G Y | CO | |
| Certified Registered Nurse Anesthetist (Crna) | CO |
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