ROGER JACQUELIN (CRNA) – Certified Registered Nurse Anesthetist, NPI 1609858406

ROGER JACQUELIN (CRNA) is a healthcare provider. based in Waconia, Minnesota. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 0001051476 (VA). The NPI Number for ROGER JACQUELIN (CRNA) is 1609858406

Main info

Male
54 Years Of Experience
Accepts Medicare Assignment
Name
ROGER JACQUELIN (CRNA)
NPI
1609858406
Phone
(952) 442-9770
Address
400 E 10TH ST
Enumeration Date
17 November 2005
Last Update Date
28 April 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8048289000
Graduation Year
1972 (54 years ago)
PAC ID
8325000441
Group Practice PAC ID
4385542117
Professional Enrollment ID
I20041101000951
Address ID
VA232195051RI1250XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,883 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in VA

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Provider Addresses for ROGER JACQUELIN (CRNA)

  • East 10th Street, Interlaken West, Waconia, Carver County, Minnesota, 55387, United States

    WACONIA, MN 553874552

    Phone: (952) 442-9770

    Fax: (952) 442-3630

    Type: Mailing

  • VCU Health Community Memorial Hospital, 125, Buena Vista Circle, South Hill, Mecklenburg County, Virginia, 23970, United States

    SOUTH HILL, VA 239701431

    Phone: (952) 442-9770

    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: 2004-11-01

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
I20041101000951ICertified Registered Nurse Anesthetist (Crna)VATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00142Anesthesia for lens surgery4137$0
00811Anesthesia for other procedure on large bowel using an endoscope1717$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1111$0
View full utilization report →

Insurance plans in this area (ZIP 55387)

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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: 4385542117View full group profile
NameSpecialtyState
Internal MedicineVA
-VA
Nurse PractitionerVA
Orthopedic SurgeryVA
O T O L A R Y N G O L O G YVA
Diagnostic RadiologyVA
Nurse PractitionerVA
Qualified AudiologistVA
Radiation OncologyVA
O T O L A R Y N G O L O G YVA

Reviews

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Frequently asked questions

What number should I use to identify ROGER JACQUELIN (CRNA) for billing?
Administrative and clinical systems typically use NPI 1609858406 for ROGER JACQUELIN (CRNA).
Does the public listing show ROGER JACQUELIN (CRNA) as active?
ROGER JACQUELIN (CRNA)'s NPI record reflects an active status in NPPES.
What services align with ROGER JACQUELIN (CRNA)'s listing?
ROGER JACQUELIN (CRNA)'s public classification highlights Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to ROGER JACQUELIN (CRNA)?
ROGER JACQUELIN (CRNA) is associated with Waconia, Minnesota in the same public data insurers reference.
Who maintains ROGER JACQUELIN (CRNA)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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