Mr Jack Colt Blaine, CRNA in Albuquerque, NM - Medicare Certified Registered Nurse Anesthetist (crna)

Mr Jack Colt Blaine, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Albuquerque, New Mexico. He graduated from nursing school in 1989 and has 35 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Yuma Regional Medical Center and his current practice location is 6709 Academy Rd Ne Ste A, Albuquerque, New Mexico. You can reach out to his office (for appointments etc.) via phone at (505) 312-4712.

Mr Jack Colt Blaine is licensed to practice in New Mexico (license number CRNA00868) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1811999642.

Contact Information

	Mr Jack Colt Blaine, CRNA
	6709 Academy Rd Ne Ste A, Albuquerque, NM 87109-3363
	(505) 312-4712
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Jack Colt Blaine
Gender	Male
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	35 Years
Location	6709 Academy Rd Ne Ste A, Albuquerque, New Mexico
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Jack Colt Blaine graduated from nursing school in 1989

NPI Data:

NPI Number: 1811999642
Provider Enumeration Date: 08/11/2005
Last Update Date: 01/19/2022

Medicare PECOS Information:

PECOS PAC ID: 6800831579
Enrollment ID: I20070911000418

Medical Identifiers

Medical identifiers for Mr Jack Colt Blaine such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1811999642	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	CRNA0061 (Arizona)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	AP108435 (Texas)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	NA1771 (California)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	CRNA00868 (New Mexico)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Yuma Regional Medical Center	Yuma, AZ	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Yuma Regional Medical Center	2062314826	288

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Jack Colt Blaine allows following entities to bill medicare on his behalf.

Entity Name	Yuma Regional Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1194706655 PECOS PAC ID: 2062314826 Enrollment ID: O20040122000526

Entity Name	Clinical Colleagues Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366958274 PECOS PAC ID: 8729011333 Enrollment ID: O20180222002396

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jack Colt Blaine is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Jack Colt Blaine, CRNA 36720 Palm Ct, Rancho Mirage, CA 92270-2206 Ph: (619) 994-2941	Mr Jack Colt Blaine, CRNA 6709 Academy Rd Ne Ste A, Albuquerque, NM 87109-3363 Ph: (505) 312-4712

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Albuquerque, NM

Francis Joseph Stoecker Iii, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1313 Dakota St Se, Albuquerque, NM 87108 Phone: 719-351-7921
Kyle Rodgers, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 6709 Academy Rd Ne Ste A, Albuquerque, NM 87109 Phone: 505-308-3145
Mr. J D Sharick, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2211 Lomas Blvd Ne, Albuquerque, NM 87106 Phone: 505-272-3119
Hideyo Tsumura, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4401 Masthead St Ne Ste 120, Albuquerque, NM 87109 Phone: 505-243-7729 Fax: 505-243-4804
Mr. Michael Bailey, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 7788 Jefferson St Ne, Albuquerque, NM 87109 Phone: 505-999-1600 Fax: 505-999-1650
David Vincent Dick, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1100 Central Ave Se, Albuquerque, NM 87106 Phone: 505-841-1234 Fax: 505-841-1956
Morgan J Ouellette Morrow, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1100 Central Ave Se, Albuquerque, NM 87106 Phone: 505-841-1234 Fax: 505-841-1956

Mr Jack Colt Blaine, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Albuquerque, NM