Doctor profile · Federal record
Dr. JACK BLAINE, CRNA
Certified Registered Nurse Anesthetist (CMS: CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)) · Certified Registered Nurse Anesthetist · Certified Registered Nurse Anesthetist · Certified Registered Nurse Anesthetist · ALBUQUERQUE, NM
- NPI 1811999642
- Accepts Medicare
- MIPS 82.4 / 100 · 2023
- 37 yrs in practice
- Licensed in 4 states
- Male
- Solo practice
- No sanctions
Practice & contact
- Primary practice
-
6709 ACADEMY RD NE STE A
ALBUQUERQUE, NM 871093363
(505) 312-4712 - Mailing address
-
36720 PALM CT
RANCHO MIRAGE, CA 922702206
Credentials & registration
- NPI registered
- August 2005 — 21 yrs on file
- Profile last updated
- January 19, 2022
- Year of graduation
- 1989 — 37 yrs since
- Specialty taxonomy
- 367500000X — NUCC code
- State licenses (4)
- New Mexico #CRNA00868 · Arizona #CRNA0061 · Texas #AP108435 · California #NA1771
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1811999642. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
377
Distinct HCPCS
4
Medicare allowed
$46,898
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
00811 |
Anesthesia for other procedure on large bowel using an endoscope | 205 | 202 | $119 | |
00731 |
Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 84 | 81 | $131 | |
00813 |
Anesthesia for procedure on small and large bowel using an endoscope | 58 | 58 | $145 | |
00812 |
Anesthesia for exam of colon using an endoscope | 30 | 30 | $99 |
In context: peer comparison
Among 28 peers in this city , average services per provider: 30. This provider delivers 13× the peer median.