Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

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

Q: 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.

Q: What is Lisa Blacketter's specialty?

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

Q: 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 33 days 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.

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: August 02, 2026.

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

On this page

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

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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.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

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

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