BENJAMIN JACOB SIDWELL (CRNA) – Certified Registered Nurse Anesthetist, NPI 1023439486

BENJAMIN JACOB SIDWELL (CRNA) is a healthcare provider. based in Edwardsville, Illinois. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 2014000650 (MO). The NPI Number for BENJAMIN JACOB SIDWELL (CRNA) is 1023439486

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
BENJAMIN JACOB SIDWELL (CRNA)
NPI
1023439486
Phone
(314) 996-5330
Address
3841 EMBER CT
Enumeration Date
2 January 2014
Last Update Date
18 March 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6187983852
Graduation Year
2013 (13 years ago)
PAC ID
9335372101
Group Practice PAC ID
4981912607
Professional Enrollment ID
I20160322000306
Address ID
IL620404701GR2100XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

1,775 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MO

Provider Addresses for BENJAMIN JACOB SIDWELL (CRNA)

  • 3841 EMBER CT

    EDWARDSVILLE, IL 620257260

    Phone: (314) 996-5330

    Type: Mailing

  • 3015 N BALLAS RD

    SAINT LOUIS, MO 631312329

    Phone: (314) 996-5330

    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: 2016-03-22

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
I20160322000306ICertified Registered Nurse Anesthetist (Crna)ILTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00811Anesthesia for other procedure on large bowel using an endoscope4040$0
00142Anesthesia for lens surgery3834$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope2927$0
00812Anesthesia for exam of colon using an endoscope2828$0
View full utilization report →

Insurance plans in this area (ZIP 62025)

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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: 4981912607View full group profile
NameSpecialtyState
-IL
Certified Registered Nurse Anesthetist (Crna)KY
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)IL
Certified Registered Nurse Anesthetist (Crna)IL
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)IL
Certified Registered Nurse Anesthetist (Crna)MO

Reviews

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Frequently asked questions

Is BENJAMIN JACOB SIDWELL (CRNA) listed with a National Provider Identifier?
Yes — BENJAMIN JACOB SIDWELL (CRNA) has NPI 1023439486 on file in the registry.
Is BENJAMIN JACOB SIDWELL (CRNA) still an active registrant?
BENJAMIN JACOB SIDWELL (CRNA) carries an active NPI according to the public dataset.
How would a patient describe BENJAMIN JACOB SIDWELL (CRNA)'s focus?
For BENJAMIN JACOB SIDWELL (CRNA), the primary taxonomy reads as Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where in Illinois is BENJAMIN JACOB SIDWELL (CRNA) registered?
Use Edwardsville, Illinois as the headline location for BENJAMIN JACOB SIDWELL (CRNA) here.
When was this NPI issued?
Enumeration for BENJAMIN JACOB SIDWELL (CRNA) is noted as January 2, 2014 where the registry provides it.

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