MS. NICHOLE CUDDEBACK (CRNA) – Certified Registered Nurse Anesthetist, NPI 1124350137
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
265 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in UT
Provider Addresses for MS. NICHOLE CUDDEBACK (CRNA)
11820 S STATE ST STE 150
DRAPER, UT 840207140
Phone: (801) 568-0200
Fax: (801) 563-0200
Type: Mailing
9660 S 1300 E
SANDY, UT 840943762
Phone: (801) 727-2056
Fax: (770) 701-6675
Type: Location
11820 S State St Ste 150
Draper, UT 840207140
Phone: (801) 568-0200
Fax: (801) 563-0200
Type: Location
1164 E Bella Vista Dr
Fruit Heights, UT 840372237
Phone: (801) 663-6438
Type: Location
PO BOX 3570
SALT LAKE CITY, UT 841103570
Phone: (801) 727-2056
Fax: (770) 701-6675
Type: Mailing
Bella Vista Drive, Fruit Heights, Davis County, Utah, 84037, United States
FRUIT HEIGHTS, UT 840372237
Phone: (801) 663-6438
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $43.
Total Amount is formed as General ($43) + Research ($0) + Ownership ($0) = $43.
Last reported payment date: 2024-10-10 • Largest payer in this snapshot: ABBVIE INC. ($24).
Total Amount
$43
General + Research + Ownership
Payments
2
Total payment records
General Amount
$43
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $24 |
| Takeda Pharmaceuticals U.S.A., Inc. | $19 |
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: 2016-10-14
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 |
|---|---|---|---|---|
| I20161014001154 | I | Certified Registered Nurse Anesthetist (Crna) | UT | 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 |
|---|---|---|---|---|
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 39 | 39 | $0 |
| 00812 | Anesthesia for exam of colon using an endoscope | 34 | 34 | $0 |
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 21 | 21 | $0 |
Insurance plans in this area (ZIP 84020)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | UT | |
| Certified Registered Nurse Anesthetist (Crna) | UT | |
| - | UT | |
| Certified Registered Nurse Anesthetist (Crna) | UT | |
| - | UT | |
| Certified Registered Nurse Anesthetist (Crna) | UT | |
| Certified Registered Nurse Anesthetist (Crna) | UT | |
| Certified Registered Nurse Anesthetist (Crna) | NV | |
| Certified Registered Nurse Anesthetist (Crna) | UT | |
| Certified Registered Nurse Anesthetist (Crna) | UT |
Reviews
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