JUSTIN TATE ENDERSBY (CRNA) – Certified Registered Nurse Anesthetist, NPI 1831138627

JUSTIN TATE ENDERSBY (CRNA) is a healthcare provider. based in Woodward, Oklahoma. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. R0084524 (OK). The NPI Number for JUSTIN TATE ENDERSBY (CRNA) is 1831138627

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
JUSTIN TATE ENDERSBY (CRNA)
NPI
1831138627
Phone
(580) 256-3956
Address
RR 1 BOX 234
Enumeration Date
6 June 2006
Last Update Date
18 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9187012300
Graduation Year
2005 (21 years ago)
PAC ID
9032122247
Group Practice PAC ID
9638461973
Professional Enrollment ID
I20060711000445
Address ID
OK740373465JE3029XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Digital endpointsOther names

669 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in OK

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Provider Addresses for JUSTIN TATE ENDERSBY (CRNA)

  • RR 1 BOX 234

    WOODWARD, OK 738019712

    Phone: (580) 256-3956

    Type: Mailing

  • AllianceHealth Woodward, 900, 17th Street, Woodward, Woodward County, Oklahoma, 73801, United States

    WOODWARD, OK 738012448

    Phone: (580) 254-8492

    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: 2006-07-11

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060711000445ICertified Registered Nurse Anesthetist (Crna)OKTBD

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
00142Anesthesia for lens surgery2625$0
View full utilization report →

Insurance plans in this area (ZIP 73801)

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Provider's Procedures

JUSTIN TATE ENDERSBY (CRNA) performs procedures in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CERTIFIED REGISTERED NURSE ANESTHETOK00142Anesthesia for lens surgery3429

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: 9638461973View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)OK
Certified Registered Nurse Anesthetist (Crna)OK
Certified Registered Nurse Anesthetist (Crna)TX
A N E S T H E S I O L O G YOK
Certified Registered Nurse Anesthetist (Crna)OK
Certified Registered Nurse Anesthetist (Crna)LA
Certified Registered Nurse Anesthetist (Crna)TX
A N E S T H E S I O L O G YGA
Certified Registered Nurse Anesthetist (Crna)OK
A N E S T H E S I O L O G YOK

Reviews

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Frequently asked questions

Does JUSTIN TATE ENDERSBY (CRNA) have a public NPI I can cite?
Public records show JUSTIN TATE ENDERSBY (CRNA) under NPI 1831138627.
Is JUSTIN TATE ENDERSBY (CRNA) currently accepting referrals based on NPI status?
Registry metadata lists JUSTIN TATE ENDERSBY (CRNA) as active.
What services align with JUSTIN TATE ENDERSBY (CRNA)'s listing?
JUSTIN TATE ENDERSBY (CRNA)'s public classification highlights Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Can patients visit JUSTIN TATE ENDERSBY (CRNA) in Woodward, Oklahoma?
For routing, start with Woodward, Oklahoma for JUSTIN TATE ENDERSBY (CRNA), then verify phone and hours locally.
Who maintains JUSTIN TATE ENDERSBY (CRNA)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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