MARY JO SMITH (CRNA) – Certified Registered Nurse Anesthetist, NPI 1528164019

MARY JO SMITH (CRNA) is a healthcare provider. based in Roseville, Minnesota. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. R1099719 (MN). The NPI Number for MARY JO SMITH (CRNA) is 1528164019

Main info

Female
37 Years Of Experience
Accepts Medicare Assignment
Name
MARY JO SMITH (CRNA)
NPI
1528164019
Phone
(651) 697-5876
Address
2700 SNELLING AVE N
Enumeration Date
15 September 2006
Last Update Date
27 October 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6512418000
Graduation Year
1989 (37 years ago)
PAC ID
2961528203
Group Practice PAC ID
5698689123
Professional Enrollment ID
I20100923001564
Address ID
MN551022344SA333XXNXXX400
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 MARY JO SMITH (CRNA)

  • 2700, Snelling Avenue North, Roseville, Ramsey County, Minnesota, 55113, United States

    SUITE 400

    ROSEVILLE, MN 551131719

    Phone: (651) 697-5876

    Type: Mailing

  • United Hospital, 333, Smith Avenue North, West Seventh - Fort Road, Saint Paul, Ramsey County, Minnesota, 55102, United States

    SAINT PAUL, MN 551022344

    Phone: (651) 735-0501

    Fax: (651) 735-1870

    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: 2010-09-23

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
I20100923001564ICertified 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 55113)

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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: 5698689123View 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
-MN
-MN
-MN
-MN
A N E S T H E S I O L O G YMN
A N E S T H E S I O L O G YMN

Reviews

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Frequently asked questions

How do I look up MARY JO SMITH (CRNA) by NPI?
Use NPI 1528164019 when you need to reference MARY JO SMITH (CRNA) in forms, claims, or directories.
Is MARY JO SMITH (CRNA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does MARY JO SMITH (CRNA) treat or focus on?
Patients typically see MARY JO SMITH (CRNA) under the specialty Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What location shows for MARY JO SMITH (CRNA)?
We surface Roseville, Minnesota for MARY JO SMITH (CRNA) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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