MR. BLAINE EMANUEL RIDER (CRNA) – Certified Registered Nurse Anesthetist, NPI 1679869168

MR. BLAINE EMANUEL RIDER (CRNA) is a healthcare provider. based in Texarkana, Texas. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. AP120948 (TX). The NPI Number for MR. BLAINE EMANUEL RIDER (CRNA) is 1679869168

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
MR. BLAINE EMANUEL RIDER (CRNA)
NPI
1679869168
Phone
(903) 614-5258
Address
2602 Saint Michael Dr Ste 301
Enumeration Date
22 June 2011
Last Update Date
13 September 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
83027862511257
Graduation Year
2011 (15 years ago)
PAC ID
7911171921
Group Practice PAC ID
7315832722
Professional Enrollment ID
I20111130000688
Address ID
TX788014809UV1025XRDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:14State licenses:2Digital endpointsOther names

5,279 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in TX

Provider Addresses for MR. BLAINE EMANUEL RIDER (CRNA)

  • 2602 Saint Michael Dr Ste 301

    Texarkana, TX 755035206

    Phone: (903) 614-5258

    Type: Location

  • 1610 LEAFHOPPER LN

    CONROE, TX 773015306

    Phone: (337) 322-4753

    Type: Mailing

  • 808 RUSSELL PALMER RD

    KINGWOOD, TX 773391689

    Phone: (281) 540-0685

    Fax: (281) 540-0684

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $37.

Total Amount is formed as General ($37) + Research ($0) + Ownership ($0) = $37.

Last reported payment date: 2024-08-28 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($37).

Total Amount

$37

General + Research + Ownership

Payments

2

Total payment records

General Amount

$37

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-28

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Merck Sharp & Dohme LLC$37
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-11-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20111130000688ICertified Registered Nurse Anesthetist (Crna)TXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
01938Anesthesia for injection, drainage or aspiration procedures on spine or spinal cord of lower back accessed through skin using imaging guidance2521$0
00812Anesthesia for exam of colon using an endoscope1111$0
View full utilization report →

Insurance plans in this area (ZIP 75503)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7315832722View full group profile
NameSpecialtyState
Diagnostic RadiologyTX
Certified Registered Nurse Anesthetist (Crna)TX
Family PracticeTX
Nurse PractitionerTX
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Family PracticeTX
Certified Registered Nurse Anesthetist (Crna)TX
Diagnostic RadiologyNC

Reviews

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Frequently asked questions

How do payers reference MR. BLAINE EMANUEL RIDER (CRNA)?
For MR. BLAINE EMANUEL RIDER (CRNA), use NPI 1679869168 as the unique 10-digit identifier.
Would MR. BLAINE EMANUEL RIDER (CRNA) appear as active to a payer?
You can treat MR. BLAINE EMANUEL RIDER (CRNA) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with MR. BLAINE EMANUEL RIDER (CRNA)?
MR. BLAINE EMANUEL RIDER (CRNA)'s record emphasizes Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where in Texas is MR. BLAINE EMANUEL RIDER (CRNA) registered?
Use Texarkana, Texas as the headline location for MR. BLAINE EMANUEL RIDER (CRNA) here.
When was this NPI issued?
Enumeration for MR. BLAINE EMANUEL RIDER (CRNA) is noted as June 22, 2011 where the registry provides it.

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