Walter Lee Blackburn, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

20A19254 Issued in CA

Practice address

3315 Watt Ave
Sacramento, CA 95821-3600

Phone

(916) 481-6800

Fax

(916) 481-1881

NPI assigned

Apr 29, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Anesthesia Service Exchange Medical Group IncGroup PAC ID 9638082530, 106 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Auburn Faith Hospital Hospital, Auburn, CA, CCN 050498
• Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wblackburn613307@hisp.ehr.sutterhealth.org

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.

• Central Anesthesia Service Exchange Medical Group, Inc.

  • Anesthesiology Physician
  • Sacramento, CA
  • NPI 1194826404

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Sacsolano Anesthesia Exchange Medical Group, Inc

  • Anesthesiology Physician
  • Sacramento, CA
  • NPI 1720401284

  Single Specialty

  NPD (past)
• Active Health Chiropractic, PC

  • Chiropractor
  • Central Point, OR
  • NPI 1780989889

  Single Specialty

  NPD (past)

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

• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Auburn, CA
  • NPI 1194774299
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Roseville, CA
  • NPI 1356390264
  Care Compare affiliation
• Sutter Valley Hospitals

  • Home Health Agency
  • Auburn, CA
  • NPI 1417987751

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1457738494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1705",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975010132",
            "telephone_number": "541-773-7273",
            "fax_number": "541-773-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 WATT AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958213600",
            "telephone_number": "916-481-6800",
            "fax_number": "916-481-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "WALTER",
        "middle_name": "LEE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "20A19254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shira Black
• Daniel Benedict Owen Blackburn
• Gertrude R. Blackburn
• Kaitlyn Jo Anne Blackburn
• Martha Louise Blackburn
• Dawn M Blacker, PH.D.
• Brandi Blackman
• Keira Irene Blackman
• Carla Blackmon, LVN
• Susan Blacksher

• Anesthesiology Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.