PAUL A MAILLOUX (CRNA) – Certified Registered Nurse Anesthetist, NPI 1720172414

PAUL A MAILLOUX (CRNA) is a healthcare provider. based in Mount clemens, Michigan. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 4704197640 (MI). The NPI Number for PAUL A MAILLOUX (CRNA) is 1720172414

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
PAUL A MAILLOUX (CRNA)
NPI
1720172414
Phone
(586) 493-8747
Address
1000 HARRINGTON BLVD
Enumeration Date
3 October 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8102759152
Graduation Year
2005 (21 years ago)
PAC ID
2264443266
Group Practice PAC ID
0143538769
Professional Enrollment ID
I20060505000016
Address ID
MI485072677FL4800XSTXX415
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

Provider Addresses for PAUL A MAILLOUX (CRNA)

  • 1000 HARRINGTON BLVD

    MOUNT CLEMENS, MI 48043

    Phone: (586) 493-8747

    Fax: (586) 493-8741

    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)

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: 2006-05-05

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
I20060505000016ICertified 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 48043)

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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: 0143538769View 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)IL
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)IL
Anesthesiology AssistantMO
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI

Reviews

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Frequently asked questions

What is the 10-digit NPI for PAUL A MAILLOUX (CRNA)?
PAUL A MAILLOUX (CRNA) — NPI 1720172414 — is the standard way to identify this listing.
Is PAUL A MAILLOUX (CRNA) listed as active for patients and plans?
The listing shows PAUL A MAILLOUX (CRNA) as active in the NPI system.
What is PAUL A MAILLOUX (CRNA) best known for clinically?
Directory data describes PAUL A MAILLOUX (CRNA) with Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where is PAUL A MAILLOUX (CRNA) based?
PAUL A MAILLOUX (CRNA) is tied to Mount Clemens, Michigan in the data we show; additional addresses may exist on the full record.
Is the information about PAUL A MAILLOUX (CRNA) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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