Active NPI
Critical Air Response Enterprises, LLC
- Air Ambulance
- Albuquerque, NM
National Provider Identifier
1114094901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Air Ambulance
- License
- F00031
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170322000241 | NM | Part B Supplier - Ambulance Service Supplier | 1456636026 | Practice locations: Albuquerque, NM; Phoenix, AZ |
National Provider Directory
National Provider DirectoryLocations
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.