MR. PHIL SECRIST (AA-S) – Anesthesiologist Assistant, NPI 1831695618
Anesthesiologist Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
205 ANESTHESIOLOGY ASSISTANT in IN
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Provider Addresses for MR. PHIL SECRIST (AA-S)
3702 NEW VISION DR BLDG B
FORT WAYNE, IN 468451703
Phone:
Type: Mailing
Parkview Plaza Drive, Fort Wayne, Allen County, Indiana, 46845, United States
FORT WAYNE, IN 46845
Phone: (260) 425-6030
Fax: (260) 425-6028
Type: Location
3000 ARLINGTON AVE STOP 1108
TOLEDO, OH 436142595
Phone: (419) 383-5322
Type: Mailing
3000 ARLINGTON AVE
TOLEDO, OH 436142598
Phone: (419) 383-3556
Fax: (419) 383-3550
Type: Location
11109 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone: (260) 425-6030
Fax: (260) 425-6028
Type: Location
615 S New Ballas Rd
Saint Louis, MO 631418221
Phone: (636) 386-9224
Fax: (636) 386-7679
Type: Location
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 468451701
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $57.
Total Amount is formed as General ($57) + Research ($0) + Ownership ($0) = $57.
Last reported payment date: 2023-06-29 • Largest payer in this snapshot: EAGLE PHARMACEUTICALS, INC. ($57).
Total Amount
$57
General + Research + Ownership
Payments
1
Total payment records
General Amount
$57
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| EAGLE PHARMACEUTICALS, INC. | $57 |
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: 2024-12-09
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20190110002979 | I | Anesthesiology Assistant | IN | TBD |
| I20241209004012 | I | Anesthesiology Assistant | OH | 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 | 35 | 35 | $0 |
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 34 | 34 | $0 |
| 00790 | Anesthesia for other procedure on upper abdomen | 11 | 11 | $0 |
Insurance plans in this area (ZIP 46845)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OH | |
| P A T H O L O G Y | OH | |
| - | OH | |
| Nurse Practitioner | OH | |
| - | OH | |
| - | OH | |
| General Surgery | ME | |
| Vascular Surgery, General Surgery | MN | |
| - | OH | |
| - | OH |
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