MR. JACOB DEAN WIEGAND – Certified Registered Nurse Anesthetist, NPI 1669006466
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
711 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in IN
Provider Addresses for MR. JACOB DEAN WIEGAND
411 W TIPTON ST
SEYMOUR, IN 472742363
Phone: (812) 522-3429
Fax: (812) 522-0790
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: 2020-06-05
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20200605002308 | I | Certified Registered Nurse Anesthetist (Crna) | IN | 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 |
|---|---|---|---|---|
| 00910 | Anesthesia for other procedure on urinary system through urethra | 22 | 20 | $0 |
| 00790 | Anesthesia for other procedure on upper abdomen | 12 | 12 | $0 |
Insurance plans in this area (ZIP 47274)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | IN | |
| O T O L A R Y N G O L O G Y | MO | |
| - | IN | |
| Family Practice | IN | |
| A N E S T H E S I O L O G Y | IN | |
| - | IN | |
| - | IN | |
| A N E S T H E S I O L O G Y | KY | |
| Medical Oncology, Internal Medicine | IN | |
| P O D I A T R Y | IN |
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