JACOB PAULK (CRNA) – Certified Registered Nurse Anesthetist, NPI 1215227202
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,710 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in GA
Provider Addresses for JACOB PAULK (CRNA)
901 18TH ST E
TIFTON, GA 317943648
Phone: (229) 353-6124
Fax: (229) 353-7722
Type: Mailing
209 TILLMAN PAULK RD
AMBROSE, GA 315123486
Phone: (229) 548-5137
Type: Mailing
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 $55.
Total Amount is formed as General ($55) + Research ($0) + Ownership ($0) = $55.
Last reported payment date: 2024-04-18 • Largest payer in this snapshot: Silk Road Medical, Inc. ($28).
Total Amount
$55
General + Research + Ownership
Payments
2
Total payment records
General Amount
$55
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Silk Road Medical, Inc. | $28 |
| Teleflex LLC | $27 |
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: 2011-12-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-12-31 (891 days ago).
Enrollment records
1
Earliest due date
2023-12-31
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 |
|---|---|---|---|---|
| I20111214000879 | I | Certified Registered Nurse Anesthetist (Crna) | GA | 2023-12-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 |
|---|---|---|---|---|
| 00142 | Anesthesia for lens surgery | 15 | 15 | $0 |
Insurance plans in this area (ZIP 31794)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | GA | |
| P A T H O L O G Y | GA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Internal Medicine | GA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Certified Registered Nurse Anesthetist (Crna) | AL | |
| Internal Medicine | GA | |
| Cardiovascular Disease (Cardiology), Nuclear Medicine | GA | |
| Emergency Medicine, Family Practice | AZ |
Reviews
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