MR. JOSE G. TANDOC (CRNA) – Certified Registered Nurse Anesthetist, NPI 1457452294
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 MR. JOSE G. TANDOC (CRNA)
56432, Edgewood Drive, Pinewood Estates, Shelby Charter Township, Macomb County, Michigan, 48316, United States
SHELBY TOWNSHIP, MI 483165832
Phone:
Type: Mailing
Lake Huron Medical Center, 2601, Electric Avenue, Grand Trunk Business Park, Port Huron, Saint Clair County, Michigan, 48060, United States
PORT HURON, MI 480606587
Phone: (810) 985-1500
Fax: (810) 966-3104
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 $154.
Total Amount is formed as General ($154) + Research ($0) + Ownership ($0) = $154.
Last reported payment date: 2023-03-24 • Largest payer in this snapshot: Edwards Lifesciences Corporation ($154).
Total Amount
$154
General + Research + Ownership
Payments
1
Total payment records
General Amount
$154
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Edwards Lifesciences Corporation | $154 |
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: 2004-09-03
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 |
|---|---|---|---|---|
| I20040903001244 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48316)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | MI | |
| - | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Pediatric Medicine, Allergy/Immunology | MI | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Physician Assistant | MI | |
| Family Practice | MI | |
| Nurse Practitioner | MI |
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