ALEXIS ROSE BOLL – Certified Registered Nurse Anesthetist, NPI 1053282772

ALEXIS ROSE BOLL is a healthcare provider. based in Chaska, Minnesota. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 3236 (MN). The NPI Number for ALEXIS ROSE BOLL is 1053282772

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
ALEXIS ROSE BOLL
NPI
1053282772
Phone
(612) 388-8814
Address
112242 HUTCHINS CT
Enumeration Date
16 September 2025
Last Update Date
20 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9529935000
Graduation Year
2025 (1 year ago)
PAC ID
8820574551
Group Practice PAC ID
7315840063
Professional Enrollment ID
I20260112003044
Address ID
MN554264702ST6500XBLVD300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

2,131 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MN

Provider Addresses for ALEXIS ROSE BOLL

  • 112242 HUTCHINS CT

    CHASKA, MN 553181546

    Phone: (612) 388-8814

    Type: Mailing

  • 6500 EXCELSIOR BLVD

    ST LOUIS PARK, MN 554264702

    Phone: (952) 993-6016

    Type: Location

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: 2026-01-12

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
I20260112003044ICertified Registered Nurse Anesthetist (Crna)MNTBD

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 55318)

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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: 7315840063View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN

Reviews

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Frequently asked questions

How do I look up ALEXIS ROSE BOLL by NPI?
Use NPI 1053282772 when you need to reference ALEXIS ROSE BOLL in forms, claims, or directories.
Is ALEXIS ROSE BOLL currently active in the NPI registry?
CMS-published data lists ALEXIS ROSE BOLL as an active registrant.
Can you summarize ALEXIS ROSE BOLL's specialty in plain language?
Clinically, the directory lists ALEXIS ROSE BOLL with Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What location shows for ALEXIS ROSE BOLL?
We surface Chaska, Minnesota for ALEXIS ROSE BOLL based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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