MRS. TARA LYNN PETTIT (CRNA, MSN) – Certified Registered Nurse Anesthetist, NPI 1205155223

MRS. TARA LYNN PETTIT (CRNA, MSN) is a healthcare provider. based in Camden, New Jersey. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA, MSN. They hold a License No. 26NR11265000 (NJ). The NPI Number for MRS. TARA LYNN PETTIT (CRNA, MSN) is 1205155223

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
MRS. TARA LYNN PETTIT (CRNA, MSN)
NPI
1205155223
Phone
(856) 342-2425
Address
1 COOPER PLZ
Enumeration Date
1 June 2010
Last Update Date
11 April 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8444485872
Graduation Year
2018 (8 years ago)
PAC ID
8628251196
Group Practice PAC ID
4082920525
Professional Enrollment ID
I20250310000106
Address ID
PA191153926PH9500XBLVD300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness75
Years active:16State licenses:2Digital endpointsOther names

1,122 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in NJ

Provider Addresses for MRS. TARA LYNN PETTIT (CRNA, MSN)

  • 1 COOPER PLZ

    CAMDEN, NJ 081031461

    Phone: (856) 342-2425

    Type: Location

  • 1 FEDERAL ST STE SW200

    CAMDEN, NJ 081031155

    Phone: (856) 356-4924

    Fax: (856) 356-4710

    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: 2025-03-10

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110321000561ICertified Registered Nurse Anesthetist (Crna)NJTBD
I20250310000106ICertified Registered Nurse Anesthetist (Crna)PATBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00811Anesthesia for other procedure on large bowel using an endoscope2323$0
00813Anesthesia for procedure on small and large bowel using an endoscope1919$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1616$0
View full utilization report →

Insurance plans in this area (ZIP 08103)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082920525View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)NJ
Certified Registered Nurse Anesthetist (Crna)PA
Certified Registered Nurse Anesthetist (Crna)PA
Certified Registered Nurse Anesthetist (Crna)PA
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)MD
Certified Registered Nurse Anesthetist (Crna)NJ
A N E S T H E S I O L O G YPA
A N E S T H E S I O L O G YNJ
Certified Registered Nurse Anesthetist (Crna)PA

Reviews

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Frequently asked questions

Is MRS. TARA LYNN PETTIT (CRNA, MSN) listed with a National Provider Identifier?
Yes — MRS. TARA LYNN PETTIT (CRNA, MSN) has NPI 1205155223 on file in the registry.
Is there an active status for MRS. TARA LYNN PETTIT (CRNA, MSN)?
For scheduling context, MRS. TARA LYNN PETTIT (CRNA, MSN) is shown as active in the registry.
How would a patient describe MRS. TARA LYNN PETTIT (CRNA, MSN)'s focus?
For MRS. TARA LYNN PETTIT (CRNA, MSN), the primary taxonomy reads as Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Is MRS. TARA LYNN PETTIT (CRNA, MSN) located near Camden?
MRS. TARA LYNN PETTIT (CRNA, MSN) currently maps to Camden, New Jersey in this extract.
When was this NPI issued?
Enumeration for MRS. TARA LYNN PETTIT (CRNA, MSN) is noted as June 1, 2010 where the registry provides it.

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