MARK KASSEBAUM (MD) – Anesthesiology Physician, NPI 1205924776
Anesthesiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
969 ANESTHESIOLOGY in MN
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Provider Addresses for MARK KASSEBAUM (MD)
CentraCare Health – Monticello, 1013, Hart Boulevard, Monticello, Wright County, Minnesota, 55362, United States of America
MONTICELLO, MN 553628575
Phone: (612) 670-0610
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: 2011-05-06
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110506000513 | I | Anesthesiology | MN | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 76942 | Ultrasonic guidance for needle placement | 32 | 32 | $0 |
| 00812 | Anesthesia for exam of colon using an endoscope | 27 | 27 | $0 |
| 64447 | Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve) | 24 | 24 | $0 |
| 01402 | Anesthesia for procedure for total knee joint replacement | 21 | 21 | $0 |
| 00630 | Anesthesia for other procedure on lower spine | 13 | 13 | $0 |
Insurance plans in this area (ZIP 55362)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| Internal Medicine | MI | |
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| Hospitalist, Internal Medicine | MN | |
| Internal Medicine, Hospitalist | MN | |
| Nurse Practitioner | MN | |
| Family Practice | MN | |
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| Family Practice, Undersea And Hyperbaric Medicine, Emergency Medicine | MN |
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