JEFFREY MANGLICMOT (CRNA) – Certified Registered Nurse Anesthetist, NPI 1043758162
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,279 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in TX
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Provider Addresses for JEFFREY MANGLICMOT (CRNA)
Band Box Place, Dallas, Dallas County, Texas, 75244, United States
DALLAS, TX 752841656
Phone: (903) 531-5000
Type: Mailing
CHRISTUS Mother Frances Hospital - Tyler, 800, East Dawson Street, Tyler, Smith County, Texas, 75701, United States
TYLER, TX 757012036
Phone: (903) 531-4522
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 15 Open Payments records for all available years, with a total value of $318.
Total Amount is formed as General ($318) + Research ($0) + Ownership ($0) = $318.
Last reported payment date: 2024-10-24 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($105).
Total Amount
$318
General + Research + Ownership
Payments
15
Total payment records
General Amount
$318
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-24
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2017-03-15
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 |
|---|---|---|---|---|
| I20170315000383 | I | Certified Registered Nurse Anesthetist (Crna) | TX | 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 |
|---|---|---|---|---|
| 01922 | Anesthesia for x-ray or radiation therapy | 23 | 23 | $0 |
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 19 | 19 | $0 |
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 16 | 16 | $0 |
| 01810 | Anesthesia for procedure on nerves, muscles, tendons, and tissue of forearm, wrist, and hand | 14 | 14 | $0 |
| 00790 | Anesthesia for other procedure on upper abdomen | 11 | 11 | $0 |
Insurance plans in this area (ZIP 75284)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | LA | |
| Family Practice | TX | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Certified Registered Nurse Anesthetist (Crna) | LA | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| - | TX | |
| Family Practice | TX |
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