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LISA DIANE BLACKETTER CRNA
NPI 1851630040
Nurse Anesthetist, Certified Registered in Port Lavaca, TX

Active since February 07, 2013Accepts Medicare Assignment
815 N VIRGINIA ST, PORT LAVACA, TX 77979(361) 552-6713 Get Directions Write a Review

NPPES record last updated: July 6, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 6, 2026, Oct 10, 2024 (2 updates tracked since 2024).

About Lisa Diane Blacketter Crna NPPES

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

LISA DIANE BLACKETTER CRNA (NPI 1851630040) is an individual nurse anesthetist, certified registered in Port Lavaca, Texas, licensed in Illinois (209010216) and active in the NPI registry since February 2013. She is affiliated with Citizens Medical Center, maintains a secondary practice location in Victoria, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1851630040
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameLISA DIANE BLACKETTERCredential: CRNA
Location Address815 N VIRGINIA STPort Lavaca, TX 77979-3025
Mailing Address815 N Virginia StPort Lavaca, TX 77979-3025 · (361) 552-0222 · Fax (361) 552-0220
Phone(361) 552-6713
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateFebruary 7, 2013
Last NPPES UpdateJuly 6, 20262 updates tracked since enumeration
NPPES CertifiedJuly 6, 2026
✔ NPI 1851630040 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
License✔ Licensed in IL · 209010216
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.
815 N VIRGINIA ST, Port Lavaca, TX 77979
Open in Google Maps ↗

Secondary Practice Location 1

Location 12701 Hospital DrVictoria, TX 77901-5749 · Phone (361) 573-9181 · Fax (361) 582-5743

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, UnitedHealthcare.Insurance ›

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

Lisa Diane Blacketter 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 ID9234375452
PECOS Enrollment IDI20230119001483

Medicare Billing Reassignments

3

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

Memorial Medical Center
Same address
Surgery
815 N VIRGINIA ST
Port Lavaca, TX 77979
  • Reassigned Medicare billing, Texas enrollment
  • 16 clinicians in this Medicare group
NPI 1104203181 (361) 552-6713
Citizen's Medical Center County Of Victoria
26 mi
Multi-Specialty
2701 HOSPITAL DR
Victoria, TX 77901
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Citizens Medical Center County Of Victoria
  • 171 clinicians in this Medicare group
NPI 1205242088 (361) 573-9181
Northstar Anesthesia III PA
77 mi
Anesthesiology
7101 S PADRE ISLAND DR
Corpus Christi, TX 78412
  • Reassigned Medicare billing, Texas enrollment
  • 740 clinicians in this Medicare group
NPI 1356968952 (214) 687-0001

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 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.
19 services19 patients

Hospital Affiliations CMS Care Compare 3

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

Citizens Medical Center

Acute Care Hospitals · Victoria, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number450023
Location2701 Hospital DriveVictoria, TX 77901 · Victoria County
Emergency services Birthing friendly

De Tar Hospital Navarro

Acute Care Hospitals · Victoria, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450147
Location506 E San Antonio StVictoria, TX 77901 · Victoria County
Emergency services Birthing friendly

Memorial Medical Center

Critical Access Hospitals · Port Lavaca, TX
OwnershipGovernment - Local
CMS Certification Number451356
Location701 N Virginia StPort Lavaca, TX 77979 · Calhoun County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77979 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ADAM NICHOLAS MYERS CRNA
Nurse Anesthetist, Certified Registered
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Calhoun County (361) 552-0222
ROBERT D COLEMAN CRNA
Nurse Anesthetist, Certified Registered
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Calhoun County (361) 573-6291
MEMORIAL MEDICAL CENTER
Surgery
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Calhoun County (361) 552-6713
KRISTI BOYD FNP-C
Nurse Practitioner (Family)
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Calhoun County (361) 552-6713
VICTORIA PROFESSIONAL MEDICAL CONSULTANTS, LLC
Emergency Medicine
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Calhoun County (361) 552-6713
MR. GREGORY WADE COWART CRNA
Nurse Anesthetist, Certified Registered
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Calhoun County (361) 552-6713
MEMORIAL MEDICAL CLINIC
General Acute Care Hospital (Critical Access)
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Calhoun County (361) 552-0224
DR. PENNY PRAPINPORN CLAY D.O.
Emergency Medicine
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Calhoun County (361) 552-0266

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 Lisa Blacketter's NPI number?

The NPI number for Lisa Blacketter is 1851630040. It was assigned to this individual provider in the NPPES registry on February 7, 2013.

Where is Lisa Blacketter located?

Lisa Blacketter practices at 815 N Virginia St, Port Lavaca, TX 77979. The listed phone number is (361) 552-6713.

What is Lisa Blacketter's specialty?

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

Is Lisa Blacketter enrolled in Medicare?

Yes. Lisa Blacketter 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 Lisa Blacketter's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Blacketter reassigns Medicare benefits to 3 organizations: Memorial Medical Center (Port Lavaca, TX), Citizen's Medical Center County Of Victoria (Victoria, TX) and Northstar Anesthesia III PA (Corpus Christi, TX). 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 Lisa Blacketter's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lisa Blacketter accept?

Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan and UnitedHealthcare list Lisa Blacketter 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.

Is Lisa Blacketter affiliated with any hospitals?

According to CMS data, Lisa Blacketter is affiliated with Citizens Medical Center, De Tar Hospital Navarro and Memorial Medical Center.

When was this NPI record last updated?

The NPPES record for Lisa Blacketter was last updated on July 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.