MARK LEROY VANDERWEIDE (CRNA) – Certified Registered Nurse Anesthetist, NPI 1225758824
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,692 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MI
Provider Addresses for MARK LEROY VANDERWEIDE (CRNA)
854 DORROLL ST NE
GRAND RAPIDS, MI 495054209
Phone: (616) 914-6532
Type: Mailing
14700 LAKE SHORE DR
CHARLEVOIX, MI 497201999
Phone: (231) 547-4024
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: 2023-03-09
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 |
|---|---|---|---|---|
| I20230309000351 | 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.
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 |
|---|---|---|---|---|
| 00142 | Anesthesia for lens surgery | 52 | 47 | $0 |
| 64450 | Injection of anesthetic agent and/or steroid into other nerve or branch | 16 | 12 | $0 |
| 76942 | Ultrasonic guidance for needle placement | 13 | 13 | $0 |
| 64415 | Injection of anesthetic agent and/or steroid into arm nerve bundle (brachial plexus) | 11 | 11 | $0 |
Insurance plans in this area (ZIP 49505)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Nurse Practitioner | MI | |
| A N E S T H E S I O L O G Y | IL | |
| Nurse Practitioner | MI | |
| - | MI | |
| - | NC | |
| - | MI | |
| Physician Assistant | MI | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OH |
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