Individual provider Active NPI

Jerry T Metcalf, CRNA

  • Certified Registered Nurse Anesthetist
  • Dekalb, IL
National Provider Identifier
1376545160
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209002136 Issued in IL
Practice address
1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone
(815) 756-1521
Fax
(815) 766-9647
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 041-255087 IL
Pain Medicine (Anesthesiology) Physician 207LP2900X 209-002136 IL
Certified Registered Nurse Anesthetist 367500000X 209002136 IL Primary

Addresses

Primary practice location

1 Kish Hospital Dr
Dekalb, IL 60115-9602

Mailing address

1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone (815) 756-1521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110221000541 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628259975 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians
CGH Medical CenterGroup PAC ID 6103723267, 199 clinicians

Practice addresses (Care Compare)

1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone (815) 766-7334

100 E Le Fevre Rd
Sterling, IL 61081-1278
Phone (815) 625-0400

5 Kish Hospital Dr
Dekalb, IL 60115-9602

515 Valley View Dr
Suite 201
Moline, IL 61265-6175
Phone (312) 695-0870

Hospital & facility affiliations

  • CGH Medical Center Hospital, Sterling, IL, CCN 140043
  • Northwestern Medicine Kishwaukee Hospital Hospital, Dekalb, IL, CCN 140286

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041-255087ILMDPain Medicine (Anesthesiology) Physician
209-002136ILMDPain Medicine (Anesthesiology) Physician
209002136ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
CGH Medical Center CurrentSince Sep 11, 2025 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 4, 2025 Accepting new patients
Valley Pain Care Centers LTD Pain Medicine CurrentSince Apr 7, 2012 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 4, 2025 Accepting new patients
CGH Medical Center CurrentSince Sep 11, 2025 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

626 Bethany Rd
DeKalb, IL 60115
Phone (815) 306-2700

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

660 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6100

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

100 5th St
Oswego, IL 60543
Phone (630) 449-0085

100 E Lefevre Rd
Sterling, IL 61081
Phone (815) 625-0400

1879 N Neltnor Blvd
West Chicago, IL 60185

Interoperability endpoints

  • Direct secure messaging: jmetcalf34131@cghmc.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1376545160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KISH HOSPITAL DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "815-756-1521",
            "fax_number": "815-766-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KISH HOSPITAL DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "815-756-1521",
            "fax_number": "815-766-9647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METCALF",
        "first_name": "JERRY",
        "middle_name": "T",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "041-255087",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "209-002136",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209002136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dekalb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.