Individual provider Active NPI

Amylia Ashley Black, CRNA

  • Certified Registered Nurse Anesthetist
  • Farmington, NM
National Provider Identifier
1881947372
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
90687 Issued in NM
Practice address
2300 E 30TH St BLDG a
Farmington, NM 87401-8991
Phone
(505) 564-2300
NPI assigned
Oct 21, 2012
Last updated
Jan 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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 90687 NM Primary

Addresses

Primary practice location

2300 E 30TH St BLDG a
Farmington, NM 87401-8991

Mailing address

3208 N Cochiti Ave
Farmington, NM 87401-2052
Phone (435) 459-9881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130218000390 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981858164 Reassigns benefits to 1 organization
I20240531003920 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981858164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
74.27
Improvement activities
40
Cost
78.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
90687NMMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Apr 6, 2024 Accepting new patients
San Juan Regional Medical Center Inc CurrentSince Dec 7, 2015 Accepting new patients
San Juan Regional Medical Center Inc Current Accepting new patients
San Juan Regional Medical Center Inc CurrentSince Dec 7, 2015 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Apr 6, 2024 Accepting new patients

Locations

4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610

801 W Maple St
Farmington, NM 87401
Phone (505) 325-5011

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.

NPI Registry JSON

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

{
    "created_epoch": "1350777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1881947372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3208 N COCHITI AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874012052",
            "telephone_number": "435-459-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 E 30TH ST BLDG A",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874018991",
            "telephone_number": "505-564-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "AMYLIA",
        "middle_name": "ASHLEY",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-21",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "90687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; 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.