Active NPI
Jay Stephen Leblanc, CRNA
- Certified Registered Nurse Anesthetist
- Plymouth, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 12812621-4406
- Practice address
- 14700 28TH Ave N Ste 20
Plymouth, MN 55447-4876 - Phone
- (765) 559-3779
- Fax
- (763) 450-3986
- NPI assigned
- Oct 11, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 12812621-4406 | UT | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | 2663 | MN |
Addresses
Primary practice location
14700 28TH Ave N Ste 20
Plymouth, MN 55447-4876
Mailing address
PO Box 47159
Plymouth, MN 55447-0159
Phone (765) 559-3779
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jleblanc645897@direct.med.utah.edu | Direct | University of Utah |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, UT
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 585-6387
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.77 of 100
- Quality
- 91.47
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.42
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12812621-4406 | UT | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NPH Anesthesia of Utah, LLC | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| Metropolitan Anesthesia Network, LLP | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients |
Locations
4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786
14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779
333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256
2221 Lakeside Blvd
Ste 600
Richardson, TX 75082
Phone (469) 998-7450
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
5475 S 500 E
South Ogden, UT 84405
Phone (801) 479-2111
1525 E 6000 S
South Ogden, UT 84405
Phone (801) 337-5800
3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810
Interoperability endpoints
- jleblanc645897@direct.med.utah.edu
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Salt Lake City, UT
- NPI 1114321981
-
- Anesthesiology Physician
- Plymouth, MN
- NPI 1558314427
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Ogden, UT
- NPI 1366077273
-
- Interventional Cardiology Physician
- Salt Lake City, UT
- NPI 1285038083
-
- Diagnostic Radiology Physician
- Salt Lake City, UT
- NPI 1598169419
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1487734976
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1588656870
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1699889576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706572800000",
"number": "1316609902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 47159",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554470159",
"telephone_number": "765-559-3779",
"fax_number": "763-450-3986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14700 28TH AVE N STE 20",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554474876",
"telephone_number": "765-559-3779",
"fax_number": "763-450-3986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEBLANC",
"first_name": "JAY",
"middle_name": "STEPHEN",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-11",
"last_updated": "2024-01-30",
"certification_date": "2024-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "UT",
"license": "12812621-4406",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "2663",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jleblanc645897@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "University of Utah",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.