ADRIENNE BACKUS – Certified Registered Nurse Anesthetist, NPI 1063956936

ADRIENNE BACKUS is a healthcare provider. based in Saint paul, Minnesota. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 114689 (MN). The NPI Number for ADRIENNE BACKUS is 1063956936

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
ADRIENNE BACKUS
NPI
1063956936
Phone
(651) 697-5804
Address
333 Smith Ave N
Enumeration Date
13 December 2016
Last Update Date
12 March 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6514395330
Graduation Year
2016 (10 years ago)
PAC ID
6901189745
Group Practice PAC ID
9133491194
Professional Enrollment ID
I20170201002761
Address ID
MN550826605ST927XXWXXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:9State licenses:1Digital endpointsOther names

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

Provider Addresses for ADRIENNE BACKUS

  • 333 Smith Ave N

    Saint Paul, MN 551022344

    Phone: (651) 697-5804

    Type: Location

  • Excelsior Boulevard, Minikahda Vista, Saint Louis Park, Hennepin County, Minnesota, 55416:55424, United States

    ST LOUIS PARK, MN 554264702

    Phone:

    Type: Mailing

  • 8170 33RD AVE S # MS 21110Q

    BLOOMINGTON, MN 554254516

    Phone:

    Type: Mailing

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: 2017-02-01

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
I20170201002761ICertified 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 55102)

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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: 9133491194View full group profile
NameSpecialtyState
-MN
Certified Registered Nurse Anesthetist (Crna)MN
-PA
Certified Registered Nurse Anesthetist (Crna)MN
A N E S T H E S I O L O G YMN
-MN
A N E S T H E S I O L O G YPA
A N E S T H E S I O L O G YMN
-MN
Certified Registered Nurse Anesthetist (Crna)WI

Reviews

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Frequently asked questions

What is ADRIENNE BACKUS's NPI number?
ADRIENNE BACKUS's NPI is 1063956936 — the number used across U.S. healthcare to identify this provider.
Is ADRIENNE BACKUS still an active registrant?
ADRIENNE BACKUS carries an active NPI according to the public dataset.
What area of care is associated with ADRIENNE BACKUS?
ADRIENNE BACKUS's record emphasizes Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Is ADRIENNE BACKUS located near Saint Paul?
ADRIENNE BACKUS currently maps to Saint Paul, Minnesota in this extract.
Does ADRIENNE BACKUS accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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