JEANETTE ILENE ELLIS (NURSE ANESTHETIST) – Certified Registered Nurse Anesthetist, NPI 1184191363
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,265 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in IL
Provider Addresses for JEANETTE ILENE ELLIS (NURSE ANESTHETIST)
809 APACHE DR
SIKESTON, MO 638014015
Phone: (573) 703-3298
Type: Mailing
2 GOOD SAMARITAN WAY STE 205
MOUNT VERNON, IL 628642476
Phone: (618) 899-3869
Fax: (618) 899-3558
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 21 Open Payments records for all available years, with a total value of $418.
Total Amount is formed as General ($418) + Research ($0) + Ownership ($0) = $418.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($137).
Total Amount
$418
General + Research + Ownership
Payments
21
Total payment records
General Amount
$418
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2019-01-11
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 |
|---|---|---|---|---|
| I20190111001188 | I | Certified Registered Nurse Anesthetist (Crna) | IL | 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 |
|---|---|---|---|---|
| 00812 | Anesthesia for exam of colon using an endoscope | 23 | 23 | $0 |
| 00910 | Anesthesia for other procedure on urinary system through urethra | 19 | 19 | $0 |
| 00914 | Anesthesia for removal of prostate including use of an endoscope | 16 | 16 | $0 |
| 01402 | Anesthesia for procedure for total knee joint replacement | 14 | 14 | $0 |
| 00840 | Anesthesia for other procedure on lower abdomen | 11 | 11 | $0 |
Insurance plans in this area (ZIP 63801)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| Nurse Practitioner | IL | |
| N E U R O L O G Y | MI | |
| Radiation Oncology | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Pain Management, Anesthesiology | IL | |
| Family Practice, Emergency Medicine | IL | |
| Nurse Practitioner | IL | |
| Family Practice | IL |
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