ANTONIO SAMUEL GERVAIS (CRNA, RN) – Certified Registered Nurse Anesthetist, NPI 1912510165

Certified Registered Nurse Anesthetist

ANTONIO SAMUEL GERVAIS (CRNA, RN) is a healthcare provider. based in Springville, Utah. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA, RN. They hold a License No. 310047 (NC). The NPI Number for ANTONIO SAMUEL GERVAIS (CRNA, RN) is 1912510165

Main info

Male

8 Years Of Experience

Accepts Medicare Assignment

Name

ANTONIO SAMUEL GERVAIS (CRNA, RN)

NPI

1912510165

Phone

(801) 687-8382

Address

499 N 880 E

Enumeration Date

27 August 2020

Last Update Date

27 August 2020

Doctor Profile

Medical School Name

OTHER

Secondary Phone

4797574000

Graduation Year

2018 (8 years ago)

PAC ID

7911327820

Group Practice PAC ID

2163524992

Professional Enrollment ID

I20240117001077

Address ID

AR727123217BE3000XPKWY400

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience43

Completeness75

Years active:5State licenses:2Digital endpointsOther names

310 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in NM

Provider Addresses for ANTONIO SAMUEL GERVAIS (CRNA, RN)

499 N 880 E
SPRINGVILLE, UT 846631156
Phone: (801) 687-8382
Type: Mailing
455 SAINT MICHAELS DR
SANTA FE, NM 875057601
Phone: (505) 913-3043
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: 2024-01-17

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

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
I20240117001077	I	Certified Registered Nurse Anesthetist (Crna)	AR	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.

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

HCPCS	Description	Services	Beneficiaries	Medicare allowed
00731	Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope	23	23	$0

View full utilization report →

Insurance plans in this area (ZIP 84663)

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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: 2163524992View full group profile

Name	Specialty	State
MRS. ALLISON MARIE LUTZ (CRNA)	Certified Registered Nurse Anesthetist (Crna)	MO
RUKMIN R HETTIARACHCHY (MD)	A N E S T H E S I O L O G Y	AR
PAULA L. SIMON (CRNA)	Certified Registered Nurse Anesthetist (Crna)	LA
AUGUST J KLOHN (CRNA)	Certified Registered Nurse Anesthetist (Crna)	LA
DR. NANCY D BRILLER (MD)	-	WA
MR. ROBERT GEISE PHILLIPS (CRNA)	Certified Registered Nurse Anesthetist (Crna)	LA
JAMES ELVIN WHEAT (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TX
JUDD TANNER BROUSSARD (CRNA)	Certified Registered Nurse Anesthetist (Crna)	LA
MR. MARK R PATIN (CRNA)	Certified Registered Nurse Anesthetist (Crna)	LA
VIRGINIA G VAN HORN (CRNA)	-	TX

Reviews

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Frequently asked questions

Is there an official ID for ANTONIO SAMUEL GERVAIS (CRNA, RN) in U.S. healthcare records?

The official identifier for ANTONIO SAMUEL GERVAIS (CRNA, RN) is NPI 1912510165.

Active or inactive — what applies to ANTONIO SAMUEL GERVAIS (CRNA, RN)?

You should see ANTONIO SAMUEL GERVAIS (CRNA, RN) as active in CMS-hosted NPPES data.

What clinical focus is listed for ANTONIO SAMUEL GERVAIS (CRNA, RN)?

At a glance, ANTONIO SAMUEL GERVAIS (CRNA, RN) is tied to Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.

Is ANTONIO SAMUEL GERVAIS (CRNA, RN) located near Springville?

ANTONIO SAMUEL GERVAIS (CRNA, RN) currently maps to Springville, Utah in this extract.

When was this NPI issued?

Enumeration for ANTONIO SAMUEL GERVAIS (CRNA, RN) is noted as August 27, 2020 where the registry provides it.