KELLY BACON – Certified Registered Nurse Anesthetist, NPI 1700844313
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
669 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in OK
Provider Addresses for KELLY BACON
PO BOX 1547
SEDALIA, MO 653021547
Phone: (660) 826-5960
Type: Mailing
1301 E LINCOLN RD
IDABEL, OK 747457300
Phone: (580) 286-7623
Type: Location
Stonecipher Boulevard, Ada, Pontotoc County, Oklahoma, 74820, United States
ADA, OK 748203439
Phone: (580) 436-3980
Fax: (580) 421-6283
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $24.
Total Amount is formed as General ($24) + Research ($0) + Ownership ($0) = $24.
Last reported payment date: 2023-09-19 • Largest payer in this snapshot: Teleflex LLC ($24).
Total Amount
$24
General + Research + Ownership
Payments
1
Total payment records
General Amount
$24
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Teleflex LLC | $24 |
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: 2021-11-01
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20211101001542 | I | Certified Registered Nurse Anesthetist (Crna) | OK | 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 |
|---|---|---|---|---|
| 00142 | Anesthesia for lens surgery | 157 | 119 | $0 |
| 00910 | Anesthesia for other procedure on urinary system through urethra | 21 | 21 | $0 |
| 01942 | Anesthesia for nerve modulation procedure spinal cord or repair of bone of spine of lower back accessed through skin using imaging guidance | 19 | 18 | $0 |
| 00103 | Anesthesia for procedure on eyelid | 13 | 13 | $0 |
Insurance plans in this area (ZIP 65302)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | OK | |
| A N E S T H E S I O L O G Y | IL | |
| - | IA | |
| Certified Registered Nurse Anesthetist (Crna) | OK | |
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| - | OK | |
| Certified Registered Nurse Anesthetist (Crna) | OK | |
| Certified Registered Nurse Anesthetist (Crna) | OK | |
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| Certified Registered Nurse Anesthetist (Crna) | AR |
Reviews
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