TAYLOR RAE TOLLEFSON (DNP) – Certified Registered Nurse Anesthetist, NPI 1316648207

TAYLOR RAE TOLLEFSON (DNP) is a healthcare provider. based in De pere, Wisconsin. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials DNP. They hold a License No. 14214-33 (WI). The NPI Number for TAYLOR RAE TOLLEFSON (DNP) is 1316648207

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
TAYLOR RAE TOLLEFSON (DNP)
NPI
1316648207
Phone
(920) 883-1459
Address
902 MANSION ST
Enumeration Date
16 March 2023
Last Update Date
5 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9204971810
Graduation Year
2023 (3 years ago)
PAC ID
4981066537
Group Practice PAC ID
6507012713
Professional Enrollment ID
I20230814001322
Address ID
WI543031858GR1077XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

1,144 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in WI

Provider Addresses for TAYLOR RAE TOLLEFSON (DNP)

  • 902 MANSION ST

    DE PERE, WI 541153242

    Phone: (920) 883-1459

    Type: Mailing

  • 835 S VAN BUREN ST

    GREEN BAY, WI 543013526

    Phone: (920) 433-0111

    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: 2023-08-14

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230814001322ICertified 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 54115)

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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: 6507012713View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)WI
Certified Registered Nurse Anesthetist (Crna)WI
Certified Registered Nurse Anesthetist (Crna)WI
Certified Registered Nurse Anesthetist (Crna)WI

Reviews

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Frequently asked questions

What identifier follows TAYLOR RAE TOLLEFSON (DNP) across health systems?
The NPI 1316648207 uniquely identifies TAYLOR RAE TOLLEFSON (DNP) in U.S. healthcare data.
Should I treat TAYLOR RAE TOLLEFSON (DNP) as an active provider?
Patients and plans typically see TAYLOR RAE TOLLEFSON (DNP) as active in the national extract.
Which specialty label fits TAYLOR RAE TOLLEFSON (DNP)?
NPPES ties TAYLOR RAE TOLLEFSON (DNP) to Certified Registered Nurse Anesthetist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to TAYLOR RAE TOLLEFSON (DNP)?
TAYLOR RAE TOLLEFSON (DNP) is associated with De Pere, Wisconsin in the same public data insurers reference.
Can I export TAYLOR RAE TOLLEFSON (DNP)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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