DR. SAMUEL R SIMS (CRNA) – Registered Nurse, NPI 1063635621
Registered Nurse
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
522 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in IA
Provider Addresses for DR. SAMUEL R SIMS (CRNA)
905 SHERMAN AVE
GRANT, NE 691403027
Phone: (712) 790-2949
Type: Mailing
344 Prairie View Dr
Carroll, IA 514013270
Phone: (803) 466-1336
Type: Location
600 W 12TH ST
IMPERIAL, NE 690333130
Phone: (308) 882-7111
Type: Location
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: 2018-12-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20110504000234 | I | Certified Registered Nurse Anesthetist (Crna) | CO | TBD |
| I20181221001492 | I | Certified Registered Nurse Anesthetist (Crna) | NE | 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 |
|---|---|---|---|---|
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 18 | 15 | $0 |
Insurance plans in this area (ZIP 69140)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | CO | |
| Nurse Practitioner | AL | |
| Family Practice | CO | |
| Family Practice | AZ | |
| Physician Assistant | NE | |
| Certified Registered Nurse Anesthetist (Crna) | NE | |
| - | CO | |
| Family Practice | CO | |
| General Surgery | CO | |
| Physician Assistant | NE |
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