Active NPI
Jacob William Krischke, CRNA
- Certified Registered Nurse Anesthetist
- Scottsdale, AZ
National Provider Identifier
1184409575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 339900
- Practice address
- 13400 E Shea Blvd
Scottsdale, AZ 85259-5499 - Phone
- (480) 301-8000
- NPI assigned
- Aug 25, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 339900 | AZ | Primary |
Addresses
Primary practice location
13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Mailing address
PO Box 860912
Minneapolis, MN 55486-0912
Other practice location 1
9026 W Quail Ave
Peoria, AZ 85382-2431
Phone (219) 241-1620
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jkrischke1421240@ehrdirect.mayoclinicmsg.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2026
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
PO Box
Minneapolis, MN 55486
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 339900 | AZ | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784505600000",
"number": "1184409575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 860912",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554860912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13400 E SHEA BLVD",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852595499",
"telephone_number": "480-301-8000"
}
],
"practiceLocations": [
{
"address_1": "9026 W Quail Ave",
"address_purpose": "LOCATION",
"city": "Peoria",
"state": "AZ",
"postal_code": "853822431",
"country_code": "US",
"telephone_number": "219-241-1620",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KRISCHKE",
"first_name": "JACOB",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-25",
"last_updated": "2026-07-20",
"certification_date": "2026-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AZ",
"license": "339900",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jkrischke1421240@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "13400 E Shea Blvd",
"city": "Scottsdale",
"state": "AZ",
"country_code": "US",
"postal_code": "852595499",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.