SAMUEL L JEFFERS (CRNA) – Certified Registered Nurse Anesthetist, NPI 1205073616
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
967 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in KS
Provider Addresses for SAMUEL L JEFFERS (CRNA)
1603 W 4th St
Holton, KS 664361153
Phone: (785) 364-3205
Fax: (785) 364-3468
Type: Location
206 S Grand Ave
Saint Marys, KS 665361637
Phone: (785) 437-3734
Fax: (785) 437-6186
Type: Location
120 W 8th St
Onaga, KS 665219574
Phone: (785) 889-4274
Fax: (785) 889-4714
Type: Location
5325, Faraon Street, St. Joseph, Buchanan County, Missouri, 64506, United States
SAINT JOSEPH, MO 645063488
Phone: (816) 271-1365
Fax: (816) 271-6753
Type: Location
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 $38.
Total Amount is formed as General ($38) + Research ($0) + Ownership ($0) = $38.
Last reported payment date: 2024-04-17 • Largest payer in this snapshot: Pacira Pharmaceuticals Incorporated ($38).
Total Amount
$38
General + Research + Ownership
Payments
1
Total payment records
General Amount
$38
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Pacira Pharmaceuticals Incorporated | $38 |
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: 2009-08-13
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090813000317 | I | Certified Registered Nurse Anesthetist (Crna) | KS | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 66436)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | KS | |
| Certified Registered Nurse Anesthetist (Crna) | KS | |
| - | KS | |
| Certified Registered Nurse Anesthetist (Crna) | KS | |
| A N E S T H E S I O L O G Y | KS | |
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| - | KS | |
| A N E S T H E S I O L O G Y | KS | |
| - | KS | |
| Certified Registered Nurse Anesthetist (Crna) | KS |
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