Individual provider Active NPI

Blake Burk, CRNA

  • Certified Registered Nurse Anesthetist
  • Phoenix, AZ
National Provider Identifier
1811676489
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
10041275 Issued in OR
Practice address
4605 E Elwood St Ste 500
Phoenix, AZ 85040-1978
Phone
(480) 256-1518
Fax
(480) 304-3446
NPI assigned
Jul 12, 2023
Last updated
Jul 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 10041275 OR Primary
Certified Registered Nurse Anesthetist 367500000X 301627 AZ
Registered Nurse 163W00000X RN9494883 FL

Addresses

Primary practice location

4605 E Elwood St Ste 500
Phoenix, AZ 85040-1978

Mailing address

4605 E Elwood St Ste 500
Phoenix, AZ 85040-1978
Phone (480) 256-1518

Other identifiers 2

IdentifierTypeStateIssuer
301627OtherAZCRNA LICENSE
RN9494883OtherFLRN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240209002815 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022451640 Reassigns benefits to 2 organizations
I20250707001763 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022451640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Washington - TCSGroup PAC ID 6800240102, 197 clinicians

Practice addresses (Care Compare)

4805 NE Glisan St
Portland, OR 97213-2933
Phone (503) 215-1111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
301627AZMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Jun 14, 2024 Accepting new patients
District Medical Group, Inc Single Specialty Current Accepting new patients
District Medical Group, Inc CurrentSince Jun 14, 2024 Accepting new patients
Anesthesia Partners of Arizona LLC Single Specialty CurrentSince Jan 1, 2024 Accepting new patients
Hospitalist Medicine Physicians of Washington - TCS Single Specialty CurrentSince Apr 24, 2025 Accepting new patients

Locations

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

8088 W Whitney Dr
Peoria, AZ 85345
Phone (602) 655-2000

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2601 E Roosevelt St
Ste 0D10
Phoenix, AZ 85008

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

4605 E Elwood St
Ste 500
Phoenix, AZ 85040
Phone (469) 998-7443

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1811676489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 E ELWOOD ST STE 500",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850401978",
            "telephone_number": "480-256-1518",
            "fax_number": "480-304-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 E ELWOOD ST STE 500",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850401978",
            "telephone_number": "480-256-1518",
            "fax_number": "480-304-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURK",
        "first_name": "BLAKE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-12",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "10041275",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "301627",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9494883",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA LICENSE",
            "identifier": "301627",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN9494883",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, 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 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.