JEFFREY MERRIAM (CRNA) – Certified Registered Nurse Anesthetist, NPI 1487657847

JEFFREY MERRIAM (CRNA) is a healthcare provider. based in Maple grove, Minnesota. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. R121082-8 (MN). The NPI Number for JEFFREY MERRIAM (CRNA) is 1487657847

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
JEFFREY MERRIAM (CRNA)
NPI
1487657847
Phone
(763) 201-8191
Address
9645 GROVE CIR N STE 250
Enumeration Date
31 May 2005
Last Update Date
13 June 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7632018191
Graduation Year
1997 (29 years ago)
PAC ID
8527963990
Group Practice PAC ID
4284879701
Professional Enrollment ID
I20031201000103
Address ID
MN553370000BU1400XSXXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:21State licenses:1Digital endpointsOther names

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

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Provider Addresses for JEFFREY MERRIAM (CRNA)

  • Grove Circle North, The Grove, Maple Grove, Hennepin County, Minnesota, 55311-1566, United States

    MAPLE GROVE, MN 553694466

    Phone: (763) 201-8191

    Fax: (763) 201-8192

    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: 2003-12-01

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
I20031201000103ICertified 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 55369)

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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: 4284879701View 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
-MN
-MN
Certified Registered Nurse Anesthetist (Crna)MN

Reviews

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Frequently asked questions

Can I use this page to confirm JEFFREY MERRIAM (CRNA)'s NPI?
Yes. JEFFREY MERRIAM (CRNA) is listed with NPI 1487657847 in the public NPI dataset.
Is JEFFREY MERRIAM (CRNA) listed as active for patients and plans?
The listing shows JEFFREY MERRIAM (CRNA) as active in the NPI system.
What healthcare role does JEFFREY MERRIAM (CRNA) hold?
Scheduling teams often label JEFFREY MERRIAM (CRNA) under Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What address line appears for JEFFREY MERRIAM (CRNA)?
JEFFREY MERRIAM (CRNA)'s geographic hint is Maple Grove, Minnesota in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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