THERESA M WELTY (CRNA) – Certified Registered Nurse Anesthetist, NPI 1700856465

THERESA M WELTY (CRNA) is a healthcare provider. based in Wyoming, Minnesota. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. R1112955 (MN). The NPI Number for THERESA M WELTY (CRNA) is 1700856465

Main info

Female
29 Years Of Experience
Accepts Medicare Assignment
Name
THERESA M WELTY (CRNA)
NPI
1700856465
Phone
(651) 464-4611
Address
5200 FAIRVIEW BLVD
Enumeration Date
25 January 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6512327000
Graduation Year
1997 (29 years ago)
PAC ID
8628042132
Group Practice PAC ID
7315986064
Professional Enrollment ID
I20041202000518
Address ID
MN551091126MA1575XAVEX300
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

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

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Provider Addresses for THERESA M WELTY (CRNA)

  • Fairview Lakes Medical Center, 5200, Fairview Boulevard, Wyoming, Chisago County, Minnesota, 55092, United States

    WYOMING, MN 550928013

    Phone: (651) 464-4611

    Fax: (651) 464-7627

    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: 2022-06-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

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
I20041202000518ICertified Registered Nurse Anesthetist (Crna)MNTBD
I20070711000624ICertified Registered Nurse Anesthetist (Crna)WITBD
I20220615002212ICertified Registered Nurse Anesthetist (Crna)AZTBD

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 55092)

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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: 7315986064View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YPA
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
A N E S T H E S I O L O G YMN
Certified Registered Nurse Anesthetist (Crna)MN
A N E S T H E S I O L O G YIA
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
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 THERESA M WELTY (CRNA) by NPI?
Use NPI 1700856465 when you need to reference THERESA M WELTY (CRNA) in forms, claims, or directories.
Is THERESA M WELTY (CRNA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does THERESA M WELTY (CRNA) treat or focus on?
Patients typically see THERESA M WELTY (CRNA) under the specialty Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What location metadata exists for THERESA M WELTY (CRNA)?
The page summarizes Wyoming, Minnesota for THERESA M WELTY (CRNA); expand the address list for detail.
What if Wyoming, Minnesota seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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