Individual provider Active NPI

Jacqueline Rachelle Kaiser, CRNA

  • Certified Registered Nurse Anesthetist
  • Albuquerque, NM
National Provider Identifier
1619203072
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R51858 Issued in NM
Practice address
7788 Jefferson St NE
Albuquerque, NM 87109-4342
Phone
(505) 999-1657
NPI assigned
Oct 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X CRNA-01067 NM
Certified Registered Nurse Anesthetist 367500000X R51858 NM Primary

Addresses

Primary practice location

7788 Jefferson St NE
Albuquerque, NM 87109-4342

Mailing address

7610 Santiago Rd SW
Albuquerque, NM 87105-7237
Phone (505) 238-3900

Other practice location 1

7610 Santiago Rd SW
Albuquerque, NM 87105-7237
Phone (505) 238-3900

Other names 1

  • Jackie Rachelle Koslan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100708000567 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648301606 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.34 of 100Reported as group
Quality
77.27
Promoting interoperability
100
Improvement activities
40
Cost
70.54

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
CRNA-01067NMMDCertified Registered Nurse Anesthetist
R51858NMMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2017 Accepting new patients
Mock Anesthesia Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1720 Wyoming Blvd NE
Albuquerque, NM 87112
Phone (505) 217-7200

4640 Jefferson Ln NE
Albuquerque, NM 87109
Phone (505) 843-6168

5150 San Francisco Rd NE
Albuquerque, NM 87109
Phone (505) 336-7711

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.

NPI Registry JSON

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1619203072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 SANTIAGO RD SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871057237",
            "telephone_number": "505-238-3900",
            "fax_number": "505-200-2954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7788 JEFFERSON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094342",
            "telephone_number": "505-999-1657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7610 Santiago Rd SW",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871057237",
            "country_code": "US",
            "telephone_number": "505-238-3900",
            "fax_number": "505-200-2954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAISER",
        "first_name": "JACQUELINE",
        "middle_name": "RACHELLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "CRNA-01067",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "R51858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "KOSLAN",
            "middle_name": "RACHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jun 27, 2022; 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.