TARA LEIGH SIMON (DNP, CRNA) – Certified Registered Nurse Anesthetist, NPI 1649991126

TARA LEIGH SIMON (DNP, CRNA) is a healthcare provider. based in Petoskey, Michigan. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials DNP, CRNA. They hold a License No. 4704326900 (MI). The NPI Number for TARA LEIGH SIMON (DNP, CRNA) is 1649991126

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
TARA LEIGH SIMON (DNP, CRNA)
NPI
1649991126
Phone
(231) 348-2795
Address
602 JACKSON ST
Enumeration Date
5 September 2022
Last Update Date
6 May 2026

Doctor Profile

Medical School Name
OAKLAND UNIV, WILLIAM BEAUMONT SCHOOL OF MEDICINE
Secondary Phone
2314874000
Graduation Year
2025 (1 year ago)
PAC ID
8527566173
Group Practice PAC ID
4789579863
Professional Enrollment ID
I20250812003435
Address ID
MI497702212PE416XXAVEX300
Data current as of
3 June 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness85
Years active:3State licenses:1Digital endpointsOther names

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

Provider Addresses for TARA LEIGH SIMON (DNP, CRNA)

  • 602 JACKSON ST

    PETOSKEY, MI 497702220

    Phone: (231) 348-2795

    Fax: (231) 348-2031

    Type: Mailing

  • 1028 EMMET ST APT B

    PETOSKEY, MI 497702930

    Phone: (231) 881-2361

    Type: Mailing

  • 620 ROSE ST

    PETOSKEY, MI 497702534

    Phone: (231) 881-2361

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2025-08-12

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
I20250812003435ICertified 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 49770)

Loading plans...

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: 4789579863View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)PA
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
Anesthesiology, Interventional Pain ManagementMI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is TARA LEIGH SIMON (DNP, CRNA)'s NPI number?
TARA LEIGH SIMON (DNP, CRNA)'s NPI is 1649991126 — the number used across U.S. healthcare to identify this provider.
Is TARA LEIGH SIMON (DNP, CRNA) still an active registrant?
TARA LEIGH SIMON (DNP, CRNA) carries an active NPI according to the public dataset.
What expertise is attributed to TARA LEIGH SIMON (DNP, CRNA)?
TARA LEIGH SIMON (DNP, CRNA)'s specialty line reads Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Is TARA LEIGH SIMON (DNP, CRNA) located near Petoskey?
TARA LEIGH SIMON (DNP, CRNA) currently maps to Petoskey, Michigan in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

Similar Providers

PAMELA A CRAWFORD (CRNA)

Certified Registered Nurse Anesthetist
602, Jackson Street, Petoskey, Emmet County, Michigan, 49770, United States
NPI: 1730280116

NANCY D JOHNSON (CRNA)

Certified Registered Nurse Anesthetist
602, Jackson Street, Petoskey, Emmet County, Michigan, 49770, United States
NPI: 1922109388

SANDRA F GIBBS (CRNA)

Certified Registered Nurse Anesthetist
602, Jackson Street, Petoskey, Emmet County, Michigan, 49770, United States
NPI: 1770684136

JONATHON JOHNSON (CRNA)

Certified Registered Nurse Anesthetist
602, Jackson Street, Petoskey, Emmet County, Michigan, 49770, United States
NPI: 1477640746

KATRINA ANN SULITIS (CRNA)

Certified Registered Nurse Anesthetist
5361 GRAHAM RD
NPI: 1578694097

HEATHER MARIE LESNIK (CRNA)

Certified Registered Nurse Anesthetist
602, Jackson Street, Petoskey, Emmet County, Michigan, 49770, United States
NPI: 1003057126

MICHELLE RENE'E GAUDREAU (CRNA)

Certified Registered Nurse Anesthetist
602 JACKSON ST
NPI: 1154626240

HEATHER JEAN SMITH (CRNA)

Certified Registered Nurse Anesthetist
416 CONNABLE AVE
NPI: 1437454493

MARK ROTHMAN (CRNA)

Certified Registered Nurse Anesthetist
602 JACKSON ST
NPI: 1659642213