MARY KATHLEEN MAGNUSEN (CRNA) – Certified Registered Nurse Anesthetist, NPI 1750427902
Certified Registered Nurse Anesthetist
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NPPES metrics only — not quality of care.
133 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in AK
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Provider Addresses for MARY KATHLEEN MAGNUSEN (CRNA)
3706, Northeast Maywood Place, Maywood Park, Portland, Metro, Multnomah County, Oregon, 97220, United States
PORTLAND, OR 972083706
Phone: (866) 907-1068
Fax: (425) 917-9141
Type: Mailing
1915, East Rezanof Drive, Kodiak, Kodiak Island, Alaska, 99615, United States
KODIAK, AK 99615
Phone: (907) 486-9500
Type: Location
1613 NW 136th Ave
Suite # 200
Sunrise, FL 33323
Phone: (954) 838-2371
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: 2018-03-09
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 |
|---|---|---|---|---|
| I20070618000220 | I | Certified Registered Nurse Anesthetist (Crna) | TX | TBD |
| I20180309001792 | I | Certified Registered Nurse Anesthetist (Crna) | AK | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97208)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| CERTIFIED REGISTERED NURSE ANESTHET | FL | 00142 | Anesthesia for lens surgery | 19 | 19 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WA | |
| General Surgery | OK | |
| Cardiovascular Disease (Cardiology) | AK | |
| Internal Medicine | AK | |
| Emergency Medicine, Family Practice | AK | |
| Family Practice | CA | |
| Family Practice | WA | |
| Emergency Medicine | AK | |
| Cardiovascular Disease (Cardiology) | AK | |
| Family Practice | AK |
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