MS. TERESA K FATUM (CRNA) – Certified Registered Nurse Anesthetist, NPI 1255444931
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
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Provider Addresses for MS. TERESA K FATUM (CRNA)
3333, Evergreen Drive Northeast, Evergreen Lake Office Park, Grand Rapids Charter Township, Kent County, Michigan, 49525, United States
GRAND RAPIDS, MI 495259756
Phone: (616) 364-4200
Fax: (616) 364-7347
Mailing address matches the actual address.
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 $20.
Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.
Last reported payment date: 2023-04-19 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($20).
Total Amount
$20
General + Research + Ownership
Payments
1
Total payment records
General Amount
$20
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-04-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Merck Sharp & Dohme LLC | $20 |
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: 2011-01-27
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 |
|---|---|---|---|---|
| I20110127000064 | 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 |
|---|---|---|---|---|
| 00812 | Anesthesia for exam of colon using an endoscope | 12 | 12 | $0 |
Insurance plans in this area (ZIP 49525)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Critical Care (Intensivists) | IL | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| - | MI | |
| Vascular Surgery | IL | |
| - | MI | |
| - | MI | |
| A N E S T H E S I O L O G Y | TX | |
| Clinical Social Worker | MI |
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