Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Jacqueline Otake

Individual provider Certified Registered Nurse Anesthetist · NPI 1720769763

Jacqueline Otake is registered under Certified Registered Nurse Anesthetist (CRNA) in Albuquerque, New Mexico. Qualified in 2024, 2 years ago. Practices with St Alphonsus Professional Medical Services LLC, a 123-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in New Hampshire, New Mexico and Texas.

Years since qualifying
2
Licensed in
NH, NM, TX
In the registry since
2023
Specialties on file
3
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Practice location Address checks out

1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone: (505) 841-1234
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 5 Alumni Dr, Exeter, NH 03833-2160 — (603) 778-7311
  • 12222 Merit Dr Ste 600, Dallas, TX 75251-3294 — (972) 715-5000

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 1229584 (TX)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 80042 (NM)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 114672-23 (NH)

Record details

NPI number1720769763
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 31, 2023
Last updated in NPPESJuly 16, 2026
Certification dateJuly 16, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice St Alphonsus Professional Medical Services Llc — 123 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients26
Services billed 38 a service is one billed item, such as a visit, a test or a procedure
Average patient age71

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

  • Exeter Hospital Inc Hospital · Exeter, NH
  • Baptist Health Louisville Hospital · Louisville, KY

Colleagues at St Alphonsus Professional Medical Services LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 123 clinicians in the practice; 12 are shown here.

Other providers in Albuquerque