MRS. TARA MACSEENE GRGURICH (CRNA) – Certified Registered Nurse Anesthetist, NPI 1619313459
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MRS. TARA MACSEENE GRGURICH (CRNA)
14288 SHIBLEY RD
GREEN CASTLE, MO 635443141
Phone: (660) 488-6598
Type: Location
1104 N BALTIMORE ST
KIRKSVILLE, MO 635012528
Phone: (660) 216-9300
Type: Mailing
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: 2013-08-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-11-30 (924 days ago).
Enrollment records
1
Earliest due date
2023-11-30
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 |
|---|---|---|---|---|
| I20130812000076 | I | Certified Registered Nurse Anesthetist (Crna) | MO | 2023-11-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 63544)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| H E M A T O L O G Y/ O N C O L O G Y | PA | |
| General Surgery | MO | |
| Family Practice | MO | |
| Psychiatry, Neurology | MO | |
| - | MO | |
| - | MO | |
| - | OH | |
| Family Practice | MO | |
| - | WA | |
| Diagnostic Radiology | MO |
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