Individual provider Active NPI

Blake Bertton Wright, DNP, CRNA

  • Certified Registered Nurse Anesthetist
  • Wausau, WI
National Provider Identifier
1982486783
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
16107-33 Issued in WI
Practice address
333 Pine Ridge Blvd
Wausau, WI 54401-4187
Phone
(715) 847-2121
Fax
(715) 847-2216
NPI assigned
Oct 17, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 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 16107-33 WI Primary

Addresses

Primary practice location

333 Pine Ridge Blvd
Wausau, WI 54401-4187

Mailing address

151938 Baneberry CT
Wausau, WI 54401-8950

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241023000194 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739612250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Wisconsin School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Wisconsin AnesthesiologyGroup PAC ID 5597667097, 57 clinicians

Practice addresses (Care Compare)

425 Pine Ridge Blvd
Suite 211
Wausau, WI 54401-4123
Phone (715) 845-5505

Hospital & facility affiliations

  • Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16107-33WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Wisconsin Anesthesiology CurrentSince Nov 25, 2024 Accepting new patients

Locations

425 Pine Ridge Blvd
Ste 211
Wausau, WI 54401
Phone (715) 845-5505

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

Organizations & group practices 1

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 10

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": "1697500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1982486783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151938 BANEBERRY CT",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544018950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 PINE RIDGE BLVD",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014187",
            "telephone_number": "715-847-2121",
            "fax_number": "715-847-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "BLAKE",
        "middle_name": "BERTTON",
        "name_prefix": "Dr.",
        "credential": "DNP, CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-17",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "16107-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.