G & G ANESTHESIA LLC – Certified Registered Nurse Anesthetist, NPI 1487020111
Certified Registered Nurse Anesthetist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for G & G ANESTHESIA LLC
7416 CREEK RIDGE LN
EDWARDSVILLE, IL 620257047
Phone: (314) 504-5140
Type: Location
2023 VADALABENE DR STE 350
MARYVILLE, IL 620625637
Phone: (618) 205-8302
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: 2021-02-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-08-31 (282 days ago).
Enrollment records
4
Earliest due date
2025-08-31
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 |
|---|---|---|---|---|
| O20150930000831 | O | Clinic/Group Practice | IL | TBD |
| O20191220000506 | O | Clinic/Group Practice | NM | 2025-08-31 |
| O20200512001499 | O | Clinic/Group Practice | CA | 2026-02-28 |
| O20210204002043 | O | Clinic/Group Practice | MO | 2026-03-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 62025)
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