Brendan Blackwelder

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

6803 Issued in WI

Practice address

3200 Pleasant Valley Rd
West Bend, WI 53095-9274

Phone

(262) 836-7300

Fax

(262) 836-7301

NPI assigned

Nov 5, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Racine Anesthesia Services LLCGroup PAC ID 8628103777, 81 clinicians

The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096
• Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Racine Anesthesia Services, LLC

  • Anesthesiology Physician
  • Mount Pleasant, WI
  • NPI 1467782748

  Nurse Anesthetist, Certified Registered, WI

  Medicare reassignment Care Compare group NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  WI

  Medicare reassignment Care Compare group NPD
• Metro Milwaukee Anesthesia Associates SC

  • Certified Registered Nurse Anesthetist
  • Brookfield, WI
  • NPI 1609130228

  Nurse Anesthetist, Certified Registered, WI

  Medicare reassignment NPD
• Laboratory Corportation of America Holdings

  • Clinical Medical Laboratory
  • Clinton, IN
  • NPI 1194140293
  NPD (past)
• Windy City Anesthesia PC

  • Certified Registered Nurse Anesthetist
  • Frankfort, IL
  • NPI 1932248622

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

• Ascension All Saints Hospital, Inc

  • General Acute Care Hospital
  • Racine, WI
  • NPI 1639123284

  Hospital

  Care Compare affiliation
• Froedtert Memorial Lutheran Hospital, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1255334173

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1902279474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 PLEASANT VALLEY RD",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959274",
            "telephone_number": "262-836-7300",
            "fax_number": "262-836-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 PLEASANT VALLEY RD",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959274",
            "telephone_number": "262-836-7300",
            "fax_number": "262-836-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELDER",
        "first_name": "BRENDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-05",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "6803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902279474",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa E Birch, PT
• Cher Kristine Birno, LPN
• Morgan Ann Birnschein, PHARMD
• Biskobing Enterprises, Inc.
• Sarah M Biskobing, RDN, CD
• Cassidy Blaney
• Gregory G Blommel
• Derek Blue, PT
• Britney Bodden
• Stacy L Boden, NP

• All providers in West Bend, WI
• Certified Registered Nurse Anesthetist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.