JEFFREY MIDDENDORF – Certified Registered Nurse Anesthetist, NPI 1073666079

JEFFREY MIDDENDORF is a healthcare provider. based in Robbinsdale, Minnesota. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. R139993-0 (MN). The NPI Number for JEFFREY MIDDENDORF is 1073666079

Main info

Female
26 Years Of Experience
Accepts Medicare Assignment
Name
JEFFREY MIDDENDORF
NPI
1073666079
Phone
Not provided
Address
3300 OAKDALE AVE N
Enumeration Date
21 January 2007
Last Update Date
22 May 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7638981000
Graduation Year
2000 (26 years ago)
PAC ID
3577640804
Group Practice PAC ID
9335033034
Professional Enrollment ID
I20080410000239
Address ID
MN553694648MA9875XDRXX300
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

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

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Provider Addresses for JEFFREY MIDDENDORF

  • North Memorial Medical Center, 3300, Oakdale Avenue North, Robbinsdale, Hennepin County, Minnesota, 55422, United States

    ROBBINSDALE, MN 554222926

    Phone:

    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: 2008-04-10

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
I20080410000239ICertified 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 55422)

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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: 9335033034View 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
-MN
Certified Registered Nurse Anesthetist (Crna)MN
A N E S T H E S I O L O G YMN
Certified Registered Nurse Anesthetist (Crna)MN

Reviews

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Frequently asked questions

How do payers reference JEFFREY MIDDENDORF?
For JEFFREY MIDDENDORF, use NPI 1073666079 as the unique 10-digit identifier.
Would JEFFREY MIDDENDORF appear as active to a payer?
You can treat JEFFREY MIDDENDORF as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is JEFFREY MIDDENDORF?
JEFFREY MIDDENDORF is associated with Certified Registered Nurse Anesthetist in the directory — Clinical services aligned with this taxonomy classification.
Is JEFFREY MIDDENDORF associated with Robbinsdale?
Public fields place JEFFREY MIDDENDORF around Robbinsdale, Minnesota. Always confirm the exact site before visiting.
Can I trust this NPI listing for JEFFREY MIDDENDORF?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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