MS. MARY ANN CRUMLISH (PA-C) – Medical Physician Assistant, NPI 1053361956
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MS. MARY ANN CRUMLISH (PA-C)
16271 BASS RD
FORT MYERS, FL 339083616
Phone: (239) 418-2918
Fax: (239) 343-7198
Type: Location
2744 GULF BREEZE PARKWAY
GULF BREEZE, FL 325633091
Phone: (850) 934-5713
Fax: (850) 934-0379
Type: Mailing
Fort Myers Post Office, North Airport Road, Lee County, Florida, 33907, United States
FORT MYERS, FL 339022147
Phone: (239) 424-1400
Fax: (239) 424-1421
Type: Mailing
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: 2004-06-04
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 |
|---|---|---|---|---|
| I20040604000548 | I | Physician Assistant | FL | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 40 | 14 | $0 |
Insurance plans in this area (ZIP 33908)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | LA | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL |
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