DOUGLAS PRUITT (CRNA) – Certified Registered Nurse Anesthetist, NPI 1366493579
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
710 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in IN
Provider Addresses for DOUGLAS PRUITT (CRNA)
600 East Blvd
Elkhart, IN 465142483
Phone: (574) 524-8130
Fax: (574) 524-8138
Type: Location
3245 HEALTH DR STE 100
GRANGER, IN 465301380
Phone: (574) 647-2129
Type: Mailing
6200 N LA CHOLLA BLVD
TUCSON, AZ 857413529
Phone: (520) 742-9000
Type: Location
541, Otis Bowen Drive, West Lakes, Munster, Lake County, Indiana, 46321, United States
MUNSTER, IN 463214158
Phone: (219) 934-5300
Type: Mailing
500, North Nappanee Street, Elkhart, Elkhart County, Indiana, 46514, United States
SUITE 11B
ELKHART, IN 465141503
Phone: (574) 522-9922
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: 2025-10-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20040102000437 | I | Certified Registered Nurse Anesthetist (Crna) | MI | TBD |
| I20050131000191 | I | Certified Registered Nurse Anesthetist (Crna) | IN | TBD |
| I20160225001770 | I | Certified Registered Nurse Anesthetist (Crna) | OH | TBD |
| I20251029004208 | I | Certified Registered Nurse Anesthetist (Crna) | AZ | 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 |
|---|---|---|---|---|
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 16 | 16 | $0 |
Insurance plans in this area (ZIP 46514)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| A N E S T H E S I O L O G Y | IL | |
| Certified Registered Nurse Anesthetist (Crna) | OH | |
| - | CA | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| - | FL | |
| A N E S T H E S I O L O G Y | CA | |
| A N E S T H E S I O L O G Y | CA | |
| A N E S T H E S I O L O G Y | MI | |
| Certified Registered Nurse Anesthetist (Crna) | PA | |
| Anesthesiology, Internal Medicine | OR |
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