IMAN MATTOX (RN) – Certified Registered Nurse Anesthetist, NPI 1417613985
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
967 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in KS
Provider Addresses for IMAN MATTOX (RN)
8080 E CENTRAL AVE STE 250
WICHITA, KS 672062367
Phone: (316) 686-7327
Fax: (316) 686-1557
Type: Mailing
28078 THORUP LN
HAYWARD, CA 945422439
Phone: (510) 885-0540
Type: Mailing
3100 TELEGRAPH AVE
OAKLAND, CA 946093239
Phone: (510) 879-9200
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: 2024-08-19
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20240217000686 | I | Certified Registered Nurse Anesthetist (Crna) | KS | TBD |
| I20240429001159 | I | Certified Registered Nurse Anesthetist (Crna) | NE | TBD |
| I20240725000494 | I | Certified Registered Nurse Anesthetist (Crna) | CA | TBD |
| I20240819004242 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 67206)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | KS | |
| Anesthesiology, Interventional Pain Management | 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) | KS | |
| A N E S T H E S I O L O G Y | OK | |
| 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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