JEFFRY LYNES PETERSON (CRNA) – Certified Registered Nurse Anesthetist, NPI 1164569729
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,265 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in IL
Provider Addresses for JEFFRY LYNES PETERSON (CRNA)
10117 PINE CREST RD
RED BUD, IL 622784458
Phone: (270) 898-1922
Mailing address matches the actual address.
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: 2015-08-18
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 |
|---|---|---|---|---|
| I20120927000800 | I | Certified Registered Nurse Anesthetist (Crna) | IL | TBD |
| I20150818005668 | I | Certified Registered Nurse Anesthetist (Crna) | MO | 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 |
|---|---|---|---|---|
| 00142 | Anesthesia for lens surgery | 15 | 11 | $0 |
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 13 | 13 | $0 |
Insurance plans in this area (ZIP 62278)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| Family Practice, Geriatric Medicine | IL | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| Family Practice | IL | |
| Nurse Practitioner | IL | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| Family Practice | IL | |
| Physician Assistant | IL | |
| Cardiovascular Disease (Cardiology) | MO | |
| Certified Registered Nurse Anesthetist (Crna) | TN |
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