Individual provider Active NPI

Blake McNamara

  • Certified Registered Nurse Anesthetist
  • New Lenox, IL
National Provider Identifier
1851153449
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209029231 Issued in IL
Practice address
1900 Silver Cross Blvd
New Lenox, IL 60451-9509
Phone
(815) 300-1100
NPI assigned
Jan 29, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209029231 IL Primary

Addresses

Primary practice location

1900 Silver Cross Blvd
New Lenox, IL 60451-9509

Mailing address

14714 Aster LN
Homer Glen, IL 60491-6968

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240513001668 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052752748 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Allied Anesthesia Associates P CGroup PAC ID 0042118069, 53 clinicians
Premier Anesthesia of Illinois Professional CorporationGroup PAC ID 1254826175, 42 clinicians

Practice addresses (Care Compare)

1900 Silver Cross Blvd
New Lenox, IL 60451-9509
Phone (815) 300-1100

350 N Wall St
Kankakee, IL 60901-2901
Phone (855) 369-7546

Hospital & facility affiliations

  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209029231ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of Illinois Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince Oct 7, 2025 Accepting new patients
Allied Anesthesia Associates, P.C. CurrentSince Mar 31, 2024 Accepting new patients

Locations

2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804

403 S Kennedy Dr
Bradley, IL 60915
Phone (815) 928-9999

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

1900 Silver Cross Blvd
New Lenox, IL 60451
Phone (815) 300-7106

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1851153449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14714 ASTER LN",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604916968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SILVER CROSS BLVD",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519509",
            "telephone_number": "815-300-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNAMARA",
        "first_name": "BLAKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209029231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

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