TIMOTHY PAUL KORDICK (CRNA) – Certified Registered Nurse Anesthetist, NPI 1174796601
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,775 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MO
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Provider Addresses for TIMOTHY PAUL KORDICK (CRNA)
PO BOX 88
POPLAR BLUFF, MO 639020088
Phone: (573) 727-2724
Fax: (573) 727-2788
Type: Mailing
2620, North Westwood Boulevard, Loma Linda, Poplar Bluff, Butler County, Missouri, 63901, United States
POPLAR BLUFF, MO 639013396
Phone: (573) 686-4111
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $71.
Total Amount is formed as General ($71) + Research ($0) + Ownership ($0) = $71.
Last reported payment date: 2024-02-20 • Largest payer in this snapshot: Medtronic, Inc. ($71).
Total Amount
$71
General + Research + Ownership
Payments
2
Total payment records
General Amount
$71
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $71 |
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: 2005-03-10
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 |
|---|---|---|---|---|
| I20050310000686 | I | Certified Registered Nurse Anesthetist (Crna) | MO | 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 |
|---|---|---|---|---|
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 36 | 35 | $0 |
| 00813 | Anesthesia for procedure on small and large bowel using an endoscope | 26 | 26 | $0 |
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 16 | 16 | $0 |
Insurance plans in this area (ZIP 63902)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| CERTIFIED REGISTERED NURSE ANESTHET | MO | 00790 | Anesthesia for procedure in upper abdomen including use of an endoscope | 12 | 12 |
| CERTIFIED REGISTERED NURSE ANESTHET | MO | 01402 | Anesthesia for open or endoscopic total knee joint replacement | 11 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | TN | |
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| Certified Registered Nurse Anesthetist (Crna) | AR | |
| Certified Registered Nurse Anesthetist (Crna) | TN | |
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| Certified Registered Nurse Anesthetist (Crna) | TN | |
| Anesthesiology, Interventional Pain Management | MO | |
| Certified Registered Nurse Anesthetist (Crna) | AR |
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