Organization Active NPI

Critical Air Response Enterprises, LLC

  • Air Ambulance
  • Albuquerque, NM
National Provider Identifier
1114094901
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Air AmbulanceTaxonomy code 3416A0800X
License
F00031 Issued in NM
Legal business name
CRITICAL AIR RESPONSE ENTERPRISES, LLC
Practice address
5345 Wyoming Blvd NE
Suite 105
Albuquerque, NM 87109-3148
Phone
(505) 242-7760
Fax
(505) 821-1113
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jake Jacobsen
Title
Managing Member
Phone
(505) 463-1543

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Air Ambulance 3416A0800X F00031 NM Primary

Addresses

Primary practice location

5345 Wyoming Blvd NE
Suite 105
Albuquerque, NM 87109-3148

Mailing address

5345 Wyoming Blvd NE
Suite 105
Albuquerque, NM 87109-3148
Phone (505) 242-7760

Other names 1

  • AirCARE1 International Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170322000241 NM Part B Supplier - Ambulance Service Supplier 1456636026 Practice locations: Albuquerque, NM; Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

732 W Deer Valley Rd
Phoenix, AZ 85027
Phone (505) 242-7760

2505 Clark Carr Loop SE
Albuquerque, NM 87106
Phone (505) 242-7760

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1114094901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5345 WYOMING BLVD NE",
            "address_2": "SUITE 105",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093148",
            "telephone_number": "505-242-7760",
            "fax_number": "505-821-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5345 WYOMING BLVD NE",
            "address_2": "SUITE 105",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093148",
            "telephone_number": "505-242-7760",
            "fax_number": "505-821-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRITICAL AIR RESPONSE ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "JACOBSEN",
        "authorized_official_first_name": "JAKE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "505-463-1543"
    },
    "taxonomies": [
        {
            "code": "3416A0800X",
            "taxonomy_group": "",
            "desc": "Ambulance, Air Transport",
            "state": "NM",
            "license": "F00031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AirCARE1 International",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.