1. Home
  2. Directory
  3. New Mexico
  4. Albuquerque
  5. Nurse Anesthetist Certified Registered
  6. NPI Profile

MR. JACK COLT BLAINE CRNA
NPI 1811999642
Nurse Anesthetist, Certified Registered in Albuquerque, NM

Active since August 11, 2005Accepts Medicare Assignment
82.37/100
CMS Quality Rating
6709 ACADEMY RD NE STE A, ALBUQUERQUE, NM 87109(505) 312-4712 Get Directions Write a Review

NPPES record last updated: January 19, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 19, 2022, Jul 3, 2016 (2 updates tracked since 2016).

About Mr. Jack Colt Blaine Crna NPPES

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

MR. JACK COLT BLAINE CRNA (NPI 1811999642) is an individual nurse anesthetist, certified registered in Albuquerque, New Mexico, licensed in New Mexico (CRNA00868) and active in the NPI registry since August 2005. He is a graduate of Other (1989).

NPPES Registry Identity

NPI1811999642
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameMR. JACK COLT BLAINECredential: CRNA
Location Address6709 ACADEMY RD NE STE AAlbuquerque, NM 87109-3363
Mailing Address36720 Palm CtRancho Mirage, CA 92270-2206 · (619) 994-2941
Phone(505) 312-4712
Sole ProprietorYes
Medical School CMSOtherGraduated 1989
Enumeration DateAugust 11, 2005
Last NPPES UpdateJanuary 19, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 19, 2022
✔ NPI 1811999642 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
Licenses✔ Licensed in NM · CRNA00868✔ Licensed in AZ · CRNA0061✔ Licensed in TX · AP108435✔ Licensed in CA · NA1771
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.
6709 ACADEMY RD NE STE A, Albuquerque, NM 87109
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Jack Colt Blaine 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 ID6800831579
PECOS Enrollment IDI20070911000418

Areas of Expertise CMS Part B claims 4

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 other procedure on large bowel using an endoscope 00811
Anesthesia for an endoscopic procedure on the large bowel ensures comfort and relaxation during the procedure. You'll be given medication to make you drowsy or asleep, eliminating any discomfort. The medication can be administered through a vein or inhaled.
130 services128 patients
Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731
This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.
66 services63 patients
Anesthesia for procedure on small and large bowel using an endoscope 00813
Anesthesia for an endoscopic procedure on the small and large bowel ensures comfort and relaxation during the procedure. It involves administering medicine to help you sleep or feel drowsy. This allows the doctor to examine your bowels without causing you discomfort or pain.
39 services39 patients
Anesthesia for exam of colon using an endoscope 00812
Anesthesia for a colon examination with an endoscope is a method used to ensure comfort during the procedure. It involves administering medication to help you relax or sleep, thus reducing discomfort as the endoscope, a thin, flexible tube, is navigated through your colon.
21 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87109 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
$126.21 typical visit price
range $54.26 – $166.80
Typical copayment $31.55 (range $13.56 – $41.70)
Most-billed visit code 99204
Established Patient
$68.00 typical visit price
range $17.00 – $135.35
Typical copayment $17.00 (range $4.25 – $33.83)
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.

82.37/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality83.57
Promoting Interoperability100
Improvement Activities40
Cost57.66

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.

KYLE RODGERS CRNA
Nurse Anesthetist, Certified Registered
6709 ACADEMY RD NE STE A
ALBUQUERQUE, NM 87109
Bernalillo County (505) 308-3145
LAURA BAUDERS CRNA
Nurse Anesthetist, Certified Registered
6709 ACADEMY RD NE STE A
ALBUQUERQUE, NM 87109
Bernalillo County (505) 308-3145
JESSE MARC LOVING DNP CRNA
Student in an Organized Health Care Education/Training Program
6709 ACADEMY RD NE STE A
ALBUQUERQUE, NM 87109
Bernalillo County (817) 764-7769
BARBARA LYNNE WERTZ CRNA
Nurse Anesthetist, Certified Registered
6709 ACADEMY RD NE STE A
ALBUQUERQUE, NM 87109
Bernalillo County (505) 308-3145
MR. EMMANUEL AJIBOLA OKEOWO CRNA
Nurse Anesthetist, Certified Registered
6709 ACADEMY RD NE STE A
ALBUQUERQUE, NM 87109
Bernalillo County (469) 767-1828
ERIKA REAKES
Nurse Anesthetist, Certified Registered
6709 ACADEMY RD NE STE A
ALBUQUERQUE, NM 87109
Bernalillo County (505) 308-3145
AUSTIN J MARSHALL
Student in an Organized Health Care Education/Training Program
6709 ACADEMY RD NE STE A
ALBUQUERQUE, NM 87109
Bernalillo County (505) 308-3145
MARIN BOERNER CRNA
Nurse Anesthetist, Certified Registered
6709 ACADEMY RD NE STE A
ALBUQUERQUE, NM 87109
Bernalillo County (505) 308-3145

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 Jack Blaine's NPI number?

The NPI number for Jack Blaine is 1811999642. It was assigned to this individual provider in the NPPES registry on August 11, 2005.

Where is Jack Blaine located?

Jack Blaine practices at 6709 Academy Rd NE Ste A, Albuquerque, NM 87109. The listed phone number is (505) 312-4712.

What is Jack Blaine's specialty?

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

Is Jack Blaine enrolled in Medicare?

Yes. Jack Blaine 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.

What insurance does Jack Blaine accept?

Health plans from Blue Cross Blue Shield of Arizona list Jack Blaine as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jack Blaine was last updated on January 19, 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.