JODY D TAVALIERI (CRNA) – Certified Registered Nurse Anesthetist, NPI 1477635746

JODY D TAVALIERI (CRNA) is a healthcare provider. based in Detroit, Michigan. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 4704165288 (MI). The NPI Number for JODY D TAVALIERI (CRNA) is 1477635746

Main info

Male
35 Years Of Experience
Accepts Medicare Assignment
Name
JODY D TAVALIERI (CRNA)
NPI
1477635746
Phone
(313) 343-4766
Address
22101 MOROSS RD
Enumeration Date
19 October 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5862285300
Graduation Year
1991 (35 years ago)
PAC ID
6800992512
Group Practice PAC ID
0941698708
Professional Enrollment ID
I20070426000019
Address ID
MI480363672CL37399RDXX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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

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Provider Addresses for JODY D TAVALIERI (CRNA)

  • St. John Hospital and Medical Center, 22101, Moross Road, Detroit, Wayne County, Michigan, 48236, United States

    DETROIT, MI 482362148

    Phone: (313) 343-4766

    Type: Location

  • Robert John Road, Saint Clair Shores, Macomb County, Michigan, 48080, United States

    SAINT CLAIR SHORES, MI 480802609

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $198.

Total Amount is formed as General ($198) + Research ($0) + Ownership ($0) = $198.

Last reported payment date: 2024-09-27 • Largest payer in this snapshot: Fisher & Paykel Healthcare Inc ($99).

Total Amount

$198

General + Research + Ownership

Payments

6

Total payment records

General Amount

$198

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-27

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2007-04-26

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070426000019ICertified Registered Nurse Anesthetist (Crna)MITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48236)

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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: 0941698708View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI

Reviews

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Frequently asked questions

Is JODY D TAVALIERI (CRNA) listed with a National Provider Identifier?
Yes — JODY D TAVALIERI (CRNA) has NPI 1477635746 on file in the registry.
Active or inactive — what applies to JODY D TAVALIERI (CRNA)?
You should see JODY D TAVALIERI (CRNA) as active in CMS-hosted NPPES data.
What area of care is associated with JODY D TAVALIERI (CRNA)?
JODY D TAVALIERI (CRNA)'s record emphasizes Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for JODY D TAVALIERI (CRNA)?
Travel planning: use Detroit, Michigan as the reference point for JODY D TAVALIERI (CRNA), then confirm.
When was this NPI issued?
Enumeration for JODY D TAVALIERI (CRNA) is noted as October 19, 2006 where the registry provides it.

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