| Jacqueline Otake, | |
|
1100 Central Ave Se, Albuquerque, NM 87106-4930 | |
| (505) 841-1234 | |
| Not Available |
| Full Name | Jacqueline Otake |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 2 Years |
| Location | 1100 Central Ave Se, Albuquerque, New Mexico |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720769763 | NPI | - | NPPES |
| Facility Name | Location | Facility Type |
|---|---|---|
| Exeter Hospital Inc | Exeter, NH | Hospital |
| Baptist Health Louisville | Louisville, KY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Professional Anesthesia Services Of Kentucky Pllc | 0244590305 | 351 |
| Anesthesia Care Group Pc | 5395646178 | 35 |
| Entity Name | Professional Anesthesia Services of Kentucky PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992212807 PECOS PAC ID: 0244590305 Enrollment ID: O20180209000936 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacqueline Otake, 8770 Washington Blvd Apt 420, Culver City, CA 90232-2482 Ph: (860) 519-6073 | Jacqueline Otake, 1100 Central Ave Se, Albuquerque, NM 87106-4930 Ph: (505) 841-1234 |
Tara Kelly, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 6709 Academy Rd Ne, Albuquerque, NM 87109 Phone: 505-308-3145 |
Francis Joseph Stoecker Iii, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare 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 |
Sarah Lew, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1100 Central Ave Se, Albuquerque, NM 87106 Phone: 505-841-1234 |
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 |