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ALYSSA ROSE BALTUSEVICH CRNA
NPI 1497370852
Nurse Anesthetist, Certified Registered in Springfield, IL

Active since June 11, 2020PECOS EnrolledAccepts Medicare Assignment
701 N 1ST ST, SPRINGFIELD, IL 62781(217) 788-3000(217) 757-2021 Get Directions Write a Review

NPPES record last updated: April 8, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 8, 2021, Jun 11, 2020 (2 updates tracked since 2020).

About Alyssa Rose Baltusevich Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALYSSA ROSE BALTUSEVICH CRNA (NPI 1497370852) is an individual nurse anesthetist, certified registered in Springfield, Illinois, licensed in Illinois (209021389) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS, is affiliated with Memorial Medical Center, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1497370852
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameALYSSA ROSE BALTUSEVICHCredential: CRNA
Location Address701 N 1ST STSpringfield, IL 62781-0001
Mailing AddressPo Box 3428Springfield, IL 62708-3428 · (217) 788-3000 · Fax (217) 757-2021
Phone(217) 788-3000
Fax(217) 757-2021
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJune 11, 2020
Last NPPES UpdateApril 8, 20212 updates tracked since enumeration
NPPES CertifiedApril 8, 2021
✔ NPI 1497370852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in IL · 209021389
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
701 N 1ST ST, Springfield, IL 62781
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Other Names 1

Former Name (1)Alyssa Rose Jimerson Crna

Other Identifiers 1

Other041437823IL · Rn License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Alyssa Rose Baltusevich Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8224450960
PECOS Enrollment IDI20200625000585
Eligible to Order & Refer✔ Part B Labs & Imaging– Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Alyssa Baltusevich reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Memorial Medical Center
Same address
Nurse Anesthetist, Certified Registered
701 N 1ST ST
Springfield, IL 62781
  • Reassigned Medicare billing, Illinois enrollment
  • 102 clinicians in this Medicare group
NPI 1255393112 (217) 788-3000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Medical Center

Acute Care Hospitals · Springfield, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140148
Location701 N First StSpringfield, IL 62702 · Sangamon County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62781 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LUCAS B STOLLER PHARMD
Pharmacist (Critical Care)
701 N 1ST ST
SPRINGFIELD, IL 62781
Sangamon County (217) 588-6402
DR. REBECCA NICHOLE MAHON PHD. DABR
Radiology (Radiological Physics)
701 N 1ST ST
SPRINGFIELD, IL 62781
Sangamon County (217) 788-3000
CAROL A GORDEN CRNA
Nurse Anesthetist, Certified Registered
701 N 1ST ST
SPRINGFIELD, IL 62781
Sangamon County (217) 788-3754
MEMORIAL HOME SERVICES
Hospice Care, Community Based
701 N 1ST ST
SPRINGFIELD, IL 62781
Sangamon County (217) 788-4663
DR. SWAPNA NEKKANTI M.D
Hospitalist
701 N 1ST ST
SPRINGFIELD, IL 62781
Sangamon County (217) 528-7541
ANN R LARSON CRNA
Nurse Anesthetist, Certified Registered
701 N 1ST ST, ANESTHESIA DEPARTMENT
SPRINGFIELD, IL 62781
Sangamon County (217) 788-3754
KELSEY A WALLACE CRNA
Nurse Anesthetist, Certified Registered
701 N 1ST ST
SPRINGFIELD, IL 62781
Sangamon County (217) 788-3000
MEMORIAL MEDICAL CENTER
Clinic/Center (Multi-Specialty)
701 N 1ST ST
SPRINGFIELD, IL 62781
Sangamon County (217) 788-3000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alyssa Baltusevich's NPI number?

The NPI number for Alyssa Baltusevich is 1497370852. It was assigned to this individual provider in the NPPES registry on June 11, 2020. The provider is also known as Alyssa Rose Jimerson Crna.

Where is Alyssa Baltusevich located?

Alyssa Baltusevich practices at 701 N 1st St, Springfield, IL 62781. The listed phone number is (217) 788-3000.

What is Alyssa Baltusevich's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Alyssa Baltusevich enrolled in Medicare?

Yes. Alyssa Baltusevich is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Alyssa Baltusevich's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Alyssa Baltusevich reassigns Medicare benefits to Memorial Medical Center (Springfield, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Alyssa Baltusevich's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Alyssa Baltusevich affiliated with any hospitals?

According to CMS data, Alyssa Baltusevich is affiliated with Memorial Medical Center.

When was this NPI record last updated?

The NPPES record for Alyssa Baltusevich was last updated on April 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.