MR. JONATHAN TODD TAKALA (CRNA) – Certified Registered Nurse Anesthetist, NPI 1124321146

Certified Registered Nurse Anesthetist

MR. JONATHAN TODD TAKALA (CRNA) is a healthcare provider. based in Kentwood, Michigan. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 4704255510 (MI). The NPI Number for MR. JONATHAN TODD TAKALA (CRNA) is 1124321146

Main info

Male

Sole Proprietor

16 Years Of Experience

Accepts Medicare Assignment

Name

MR. JONATHAN TODD TAKALA (CRNA)

NPI

1124321146

Phone

(906) 250-9060

Address

3375 BRETON VALLEY DR SE

Enumeration Date

14 December 2010

Last Update Date

20 December 2017

Doctor Profile

Medical School Name

OTHER

Secondary Phone

2319243300

Graduation Year

2010 (16 years ago)

PAC ID

9234312091

Group Practice PAC ID

7911895164

Professional Enrollment ID

I20110331000891

Address ID

MI494121548FR212XXAVEX400

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience49

Completeness75

Years active:15State licenses:1Digital endpointsOther names

2,692 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MI

Provider Addresses for MR. JONATHAN TODD TAKALA (CRNA)

3375 BRETON VALLEY DR SE
KENTWOOD, MI 495129064
Phone: (906) 250-9060
Type: Mailing
3333 EVERGREEN DR NE
GRAND RAPIDS, MI 495259493
Phone: (616) 364-4200
Fax: (616) 364-7347
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: 2011-03-31

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

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
I20110331000891	I	Certified Registered Nurse Anesthetist (Crna)	MI	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.

Verify on CMS Revalidation Lookup Tool

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
00812	Anesthesia for exam of colon using an endoscope	23	23	$0

View full utilization report →

Insurance plans in this area (ZIP 49512)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 7911895164View full group profile

Name	Specialty	State
REBECCA S MOODY (CRNA)	Certified Registered Nurse Anesthetist (Crna)	MI
DYLAN M MEYER (RN, BSN)	Certified Registered Nurse Anesthetist (Crna)	MI
Unknown Individual	-	MI
MR. STEVEN JOHN DICKERSON (CRNA)	-	MI
MS. ROSEMARY DOTY (CRNA)	-	IN
KELLEY LABONTY (CRNA)	-	MI
DEBORAH A DULMAN (CRNA)	Certified Registered Nurse Anesthetist (Crna)	MI
BERNARD J BETKA (CRNA)	Certified Registered Nurse Anesthetist (Crna)	MI
BETH CROFUT (CRNA)	Certified Registered Nurse Anesthetist (Crna)	MI
MS. SHAREE LYNN HOYT (CRNA)	Certified Registered Nurse Anesthetist (Crna)	MI

Reviews

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Frequently asked questions

How do I look up MR. JONATHAN TODD TAKALA (CRNA) by NPI?

Use NPI 1124321146 when you need to reference MR. JONATHAN TODD TAKALA (CRNA) in forms, claims, or directories.

Is MR. JONATHAN TODD TAKALA (CRNA) currently active in the NPI registry?

CMS-published data lists MR. JONATHAN TODD TAKALA (CRNA) as an active registrant.

What field does MR. JONATHAN TODD TAKALA (CRNA) work in?

You can think of MR. JONATHAN TODD TAKALA (CRNA) as practicing within Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.

Where does public data place MR. JONATHAN TODD TAKALA (CRNA)?

The snapshot lists Kentwood, Michigan for MR. JONATHAN TODD TAKALA (CRNA); download NPPES for the complete set.

Is this NPI for an individual or an organization?

This listing corresponds to an Individual Provider.