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JACOB DAVID SANDEFUR CRNA
NPI 1770212417
Nurse Anesthetist, Certified Registered in La Grande, OR

Active since June 08, 2022PECOS EnrolledAccepts Medicare Assignment
71.93/100
CMS Quality Rating
900 SUNSET DR, LA GRANDE, OR 97850(541) 963-8421 Get Directions Write a Review

NPPES record last updated: September 23, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 23, 2022, Jun 8, 2022 (2 updates tracked since 2022).

About Jacob David Sandefur Crna NPPES

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

JACOB DAVID SANDEFUR CRNA (NPI 1770212417) is an individual nurse anesthetist, certified registered in La Grande, Oregon, licensed in Oregon (202214569CRNAPP) and active in the NPI registry since June 2022. He is enrolled in Medicare PECOS, is affiliated with Grande Ronde Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1770212417
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameJACOB DAVID SANDEFURCredential: CRNA
Location Address900 SUNSET DRLa Grande, OR 97850-1387
Mailing Address2302 E N CtLa Grande, OR 97850-3858 · (541) 519-0890
Phone(541) 963-8421
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateJune 8, 2022
Last NPPES UpdateSeptember 23, 20222 updates tracked since enumeration
NPPES CertifiedJuly 12, 2022
✔ NPI 1770212417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in OR · 202214569CRNAPP
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.
Also ListedRegistered NurseTaxonomy 163W00000X · License 239503 (TN)
900 SUNSET DR, La Grande, OR 97850
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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

Jacob David Sandefur 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 ID8426425588
PECOS Enrollment IDI20221101003476, I20231030001695
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 Reassignments

3

Medicare enrollment records show Jacob Sandefur reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Grande Ronde Hospital, Inc.
Same address
Critical Access
900 SUNSET DR
La Grande, OR 97850
  • Reassigned Medicare billing, Oregon enrollment
  • 158 clinicians in this Medicare group
NPI 1467446195 (541) 963-1472
Evergreen Anesthesia Associates, LLC
115 mi
Nurse Anesthetist, Certified Registered
1016 TACOMA AVE
Sunnyside, WA 98944
  • Reassigned Medicare billing, Washington enrollment
  • 42 clinicians in this Medicare group
NPI 1225575996 (509) 823-6682
Advanced Anesthesia Services, PLLC
251 mi
Nurse Anesthetist, Certified Registered
1260 116TH AVE NE STE 110
Bellevue, WA 98004
  • Reassigned Medicare billing, Washington enrollment
  • 56 clinicians in this Medicare group
NPI 1700211786 (206) 330-6722

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

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for lens surgery 00142
Anesthesia for lens surgery involves administering medication to numb the eye area, ensuring you feel no pain during the procedure. This can be a local anesthetic (numbing only the eye area) or general (where you're asleep). It helps make the surgery comfortable and stress-free.
36 services35 patients

Hospital Affiliations CMS Care Compare 2

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

Grande Ronde Hospital

Critical Access Hospitals · La Grande, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number381321
Location900 Sunset DriveLa Grande, OR 97850 · Union County
Emergency services Birthing friendly

Kittitas Valley Community Hospital

Critical Access Hospitals · Ellensburg, WA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number501333
Location603 South ChestnutEllensburg, WA 98926 · Kittitas County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97850 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
$126.25 typical visit price
range $54.96 – $166.64
Typical copayment $31.56 (range $13.74 – $41.66)
Most-billed visit code 99204
Established Patient
$68.64 typical visit price
range $17.68 – $136.19
Typical copayment $17.16 (range $4.42 – $34.04)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

71.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality90.53
Promoting Interoperability100
Improvement Activities40
Cost10

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.

DANIELLE KIGGINS SISUL
Emergency Medicine
900 SUNSET DR
LA GRANDE, OR 97850
Union County (541) 963-8421
DR. GERALDINE GARDNER D.O.
Internal Medicine (Cardiovascular Disease)
900 SUNSET DR
LA GRANDE, OR 97850
Union County (541) 963-2328
SCOTT ALDEN WIDENER FNP-C
Nurse Practitioner
900 SUNSET DR
LA GRANDE, OR 97850
Union County (541) 963-1412
AARON WELLS GRIGG MD
Pediatrics
900 SUNSET DR
LA GRANDE, OR 97850
Union County (541) 663-3159
BAYLEE NANETTE SWALES RNFA
Registered Nurse (Registered Nurse First Assistant)
900 SUNSET DR
LA GRANDE, OR 97850
Union County (541) 963-8421
SEYMOUR MAYNARD BRONSTEIN M.D.
Internal Medicine (Hematology & Oncology)
900 SUNSET DR
LA GRANDE, OR 97850
Union County (541) 963-2828
AARON SPRACKLEN DO PC
Anesthesiology
900 SUNSET DR
LA GRANDE, OR 97850
Union County (541) 963-8421
KORREENE ANN DUBRAY
Nurse Practitioner (Adult Health)
900 SUNSET DR
LA GRANDE, OR 97850
Union County (541) 963-8421

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 Jacob Sandefur's NPI number?

The NPI number for Jacob Sandefur is 1770212417. It was assigned to this individual provider in the NPPES registry on June 8, 2022.

Where is Jacob Sandefur located?

Jacob Sandefur practices at 900 Sunset Dr, La Grande, OR 97850. The listed phone number is (541) 963-8421.

What is Jacob Sandefur's specialty?

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

Is Jacob Sandefur enrolled in Medicare?

Yes. Jacob Sandefur 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 organizations bill Medicare for Jacob Sandefur's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Sandefur reassigns Medicare benefits to 3 organizations: Grande Ronde Hospital, Inc. (La Grande, OR), Evergreen Anesthesia Associates, LLC (Sunnyside, WA) and Advanced Anesthesia Services, PLLC (Bellevue, WA). Each 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 Jacob Sandefur's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Jacob Sandefur affiliated with any hospitals?

According to CMS data, Jacob Sandefur is affiliated with Grande Ronde Hospital and Kittitas Valley Community Hospital.

When was this NPI record last updated?

The NPPES record for Jacob Sandefur was last updated on September 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.