Blake Hawk, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

28198864A Issued in IN

Practice address

600 East Blvd
Elkhart, IN 46514-2483

Phone

(574) 523-3193

NPI assigned

Oct 27, 2016

Last updated

Oct 27, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Australia Anesthesia Management LLCGroup PAC ID 9436671864, 58 clinicians

United Surgeons LLCGroup PAC ID 0941260061, 22 clinicians

Saint Joseph Regional Medical Center-South Bend Campus IncGroup PAC ID 3476451790, 65 clinicians

Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012
• Goshen Hospital Hospital, Goshen, IN, CCN 150026

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Australia Anesthesia Management LLC

  • Anesthesiology Physician
  • Goshen, IN
  • NPI 1700601903
  Medicare reassignment Care Compare group NPD
• Cep America - Anesthesia PC

  • Anesthesiology Physician
  • Mishawaka, IN
  • NPI 1306722418
  Medicare reassignment Care Compare group NPD
• Saint Joseph Regional Medical Center-South Bend Campus, Inc

  dba Saint Joseph Regional Medical Center-South Bend Campus Inc Mobile Med

  • Mobile Mammography Clinic/Center
  • South Bend, IN
  • NPI 1023844693
  Medicare reassignment Care Compare group NPD
• United Surgeons, LLC

  dba Unity Physicians Hospital

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1518197011
  Medicare reassignment Care Compare group NPD
• Jebs Anesthesia Consultants, LLC

  • Anesthesiology Physician
  • La Porte, IN
  • NPI 1790447761
  Medicare reassignment NPD
• Saint Joseph Regional Medical Center-South Bend Campus, Inc

  • Critical Care Medicine (Internal Medicine) Physician
  • Mishawaka, IN
  • NPI 1699132365

  Nurse Anesthetist, Certified Registered

  NPD
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1841245594
  NPD
• Cep America - Anesthesia PC

  • Anesthesiology Physician
  • Langhorne, PA
  • NPI 1093678229
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Goshen Hospital Association Inc

  • General Acute Care Hospital
  • Goshen, IN
  • NPI 1740268846
  Care Compare affiliation
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1023965795
  Care Compare affiliation
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1841245594
  Care Compare affiliation

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1417409251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 ORCHARD PARK DR",
            "city": "WAKARUSA",
            "state": "IN",
            "postal_code": "465739738",
            "telephone_number": "574-354-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 EAST BLVD",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142483",
            "telephone_number": "574-523-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWK",
        "first_name": "BLAKE",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-27",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28198864A",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN.400991",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Autumn A Hatton
• Russell Alan Hauge, CRNA
• Mark Havard, SPEECH PATHOLOGIST
• Mary Helen P Havran-Znavor, NP
• Madeline Havrilla, MS
• Barbara Hawkins-Cleveland, MS.ED
• Tyler Thomas Hawkins, PTA
• Mary Hay, SLP
• Adrienne Hayden
• Paula Georgeann Haynes

• Certified Registered Nurse Anesthetist in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Certified Registered Nurse Anesthetist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; 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.

Verify at the official NPI Registry.