MARLIN LEE JOLLY – Certified Registered Nurse Anesthetist, NPI 1174000913

MARLIN LEE JOLLY is a healthcare provider. based in Tacoma, Washington. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. C003250 (AR). The NPI Number for MARLIN LEE JOLLY is 1174000913

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
MARLIN LEE JOLLY
NPI
1174000913
Phone
Not provided
Address
9040 JACKSON AVE
Enumeration Date
24 July 2018
Last Update Date
24 July 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4793388000
Graduation Year
2018 (8 years ago)
PAC ID
5698180453
Group Practice PAC ID
3173056298
Professional Enrollment ID
I20210916000727
Address ID
AR727581452RO2710XLNXX500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

987 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in WA

Loading map...

Provider Addresses for MARLIN LEE JOLLY

  • Madigan Army Medical Center, 9040, Jackson Avenue, Tacoma, Pierce County, Washington, 98431, United States

    TACOMA, WA 984310001

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2021-09-16

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
I20210916000727ICertified Registered Nurse Anesthetist (Crna)ARTBD

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
00902Anesthesia for procedure on anus and rectum2727$0
00910Anesthesia for other procedure on urinary system through urethra2120$0
00670Anesthesia for extensive surgery on spine1414$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1111$0
00811Anesthesia for other procedure on large bowel using an endoscope1111$0
View full utilization report →

Insurance plans in this area (ZIP 98431)

Loading plans...

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: 3173056298View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)SC
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)OK
Certified Registered Nurse Anesthetist (Crna)OK
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)MO
A N E S T H E S I O L O G YAR
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)AR

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I verify MARLIN LEE JOLLY with an NPI only?
You can start verification with NPI 1174000913 for MARLIN LEE JOLLY, then check state licensing separately.
Does the file indicate MARLIN LEE JOLLY is practicing under active NPI?
Directory data currently reports MARLIN LEE JOLLY as active.
What taxonomy line describes MARLIN LEE JOLLY?
For research purposes, treat MARLIN LEE JOLLY as Certified Registered Nurse Anesthetist in this dataset. Clinical services aligned with this taxonomy classification.
Does MARLIN LEE JOLLY list a practice location?
Patients near Tacoma, Washington may find MARLIN LEE JOLLY in results; validate coverage separately.
Is the information about MARLIN LEE JOLLY up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

Similar Providers

South Union Avenue, Tacoma, Pierce County, Washington, 98405-1326, United States
NPI: 1235133067

MR. JOHN E BUONORA (CRNA)

Certified Registered Nurse Anesthetist
PO BOX 31001-1525
NPI: 1356345185

CHARLES A DARLING (CRNA)

Certified Registered Nurse Anesthetist
Madigan Army Medical Center, 9040, Jackson Avenue, Tacoma, Pierce County, Washington, 98431, United States
NPI: 1356340335
9040 FITZSIMMONS DR
NPI: 1669464483

OHOP VALLEY ANESTHESIA, INC.

Certified Registered Nurse Anesthetist
PO BOX 955
NPI: 1720075674

VICTORIA BUSKA (CRNA)

Certified Registered Nurse Anesthetist
Madigan Army Medical Center, 9040, Jackson Avenue, Tacoma, Pierce County, Washington, 98431, United States
NPI: 1376531384

MS. MICHELLE JANE BOSTON (CRNA)

Certified Registered Nurse Anesthetist
1910, Charles Street, DuPont, Pierce County, Washington, 98327, United States
NPI: 1184600769

MR. KELLY SHAUN SIMPSON (CRNA)

Certified Registered Nurse Anesthetist
1642 PARKSIDE CIR
NPI: 1497732903