THOMAS WILLIAM JORGENSEN – Certified Registered Nurse Anesthetist, NPI 1093220089

THOMAS WILLIAM JORGENSEN is a healthcare provider. based in Ashland, Wisconsin. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 2182 (MN). The NPI Number for THOMAS WILLIAM JORGENSEN is 1093220089

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
THOMAS WILLIAM JORGENSEN
NPI
1093220089
Phone
(715) 685-5500
Address
1615 MAPLE LN
Enumeration Date
12 December 2017
Last Update Date
10 September 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7156825500
Graduation Year
2018 (8 years ago)
PAC ID
8426319138
Group Practice PAC ID
8022000447
Professional Enrollment ID
I20191112000075
Address ID
WI548063626AS1615XLNXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:8State licenses:2Digital endpointsOther names

1,141 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in WI

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Provider Addresses for THOMAS WILLIAM JORGENSEN

  • Memorial Medical Center, 1615, Maple Lane, Ashland, Ashland County, Wisconsin, 54806, United States

    ASHLAND, WI 548063689

    Phone: (715) 685-5500

    Mailing address matches the actual address.

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: 2019-11-12

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
I20191112000075ICertified Registered Nurse Anesthetist (Crna)WITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 54806)

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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: 8022000447View full group profile
NameSpecialtyState
Nurse PractitionerWI
-WI
Orthopedic SurgeryWI
Physician AssistantWI
Nurse PractitionerWI
O P H T H A L M O L O G YLA
Nurse PractitionerWI
Physician AssistantWI
U R O L O G YCO
Orthopedic SurgeryMN

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Frequently asked questions

How do I look up THOMAS WILLIAM JORGENSEN by NPI?
Use NPI 1093220089 when you need to reference THOMAS WILLIAM JORGENSEN in forms, claims, or directories.
Is THOMAS WILLIAM JORGENSEN's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does THOMAS WILLIAM JORGENSEN work in?
You can think of THOMAS WILLIAM JORGENSEN as practicing within Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What location metadata exists for THOMAS WILLIAM JORGENSEN?
The page summarizes Ashland, Wisconsin for THOMAS WILLIAM JORGENSEN; expand the address list for detail.
How can I contact THOMAS WILLIAM JORGENSEN?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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