| Providence Alaska Medical Center | |
|
3200 Providence Drive Anchorage AK 99506-4615 | |
| (907) 212-6522 | |
| (907) 212-6593 |
| Full Name | Providence Alaska Medical Center |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 3200 Providence Drive, Anchorage, Alaska |
| Authorized Official Name and Position | Donald Anderson (DIRECTOR REIMBURSEMENT ADMIN) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Alaska Medical Center Po Box 4105 Portland OR 97208-4105 Ph: (866) 907-1068 | Providence Alaska Medical Center 3200 Providence Drive Anchorage AK 99506-4615 Ph: (907) 212-6522 |
| NPI Number | 1467547265 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 08/17/2016 |
| Medicare PECOS PAC ID | 2163335746 |
|---|---|
| Medicare Enrollment ID | O20031110000525 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467547265 | NPI | - | NPPES |
| 0000ZBBBD | Other | AK | MEDICARE GROUP NUMBER |
| 02-0001 | Other | AK | PTAN |
| MDG7981 | Medicaid | AK | |
| MDG798 | Medicaid | AK | |
| MDG7982 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 282N00000X | General Acute Care Hospital | (* (Not Available)) | Primary |
| Provider Name | Lina J Bautista |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982625596 PECOS PAC ID: 2567358872 Enrollment ID: I20040224000948 |
| Provider Name | Beth A Baker |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1184606956 PECOS PAC ID: 0648260935 Enrollment ID: I20040518000776 |
| Provider Name | Linda A Ireland |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588689368 PECOS PAC ID: 3779553607 Enrollment ID: I20040728001248 |
| Provider Name | Lisa N Gray |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912922329 PECOS PAC ID: 8527039320 Enrollment ID: I20040804001389 |
| Provider Name | Stanley P Watkins |
|---|---|
| Provider Type | Practitioner - Peripheral Vascular Disease |
| Provider Identifiers | NPI Number: 1548294945 PECOS PAC ID: 3971537762 Enrollment ID: I20050921000582 |
| Provider Name | Adam C Mason |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1902824287 PECOS PAC ID: 6608891833 Enrollment ID: I20051006000995 |
| Provider Name | Mark A Selland |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669490900 PECOS PAC ID: 7113826926 Enrollment ID: I20060725000033 |
| Provider Name | Richard A Anschuetz |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1386669174 PECOS PAC ID: 3870492689 Enrollment ID: I20060725000041 |
| Provider Name | Steven J Compton |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1548285901 PECOS PAC ID: 3678472487 Enrollment ID: I20060725000061 |
| Provider Name | Krzysztof W Balaban |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1528083334 PECOS PAC ID: 6305859075 Enrollment ID: I20060725000079 |
| Provider Name | John C Finley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1275558637 PECOS PAC ID: 1850290669 Enrollment ID: I20060725000137 |
| Provider Name | William P Mayer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437177714 PECOS PAC ID: 5597664300 Enrollment ID: I20060725000148 |
| Provider Name | Mario Binder |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265457022 PECOS PAC ID: 4789697475 Enrollment ID: I20060725000260 |
| Provider Name | Alan E Skolnick |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548287121 PECOS PAC ID: 5092796524 Enrollment ID: I20060725000269 |
| Provider Name | Seth L Krauss |
|---|---|
| Provider Type | Practitioner - Peripheral Vascular Disease |
| Provider Identifiers | NPI Number: 1801814173 PECOS PAC ID: 9335048149 Enrollment ID: I20060726000006 |
| Provider Name | Thomas K Kramer |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1083635742 PECOS PAC ID: 6103725916 Enrollment ID: I20060726000274 |
| Provider Name | Brian T Scully |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1841209368 PECOS PAC ID: 7416952635 Enrollment ID: I20060921000646 |
| Provider Name | Jonathan R Mcdonagh |
|---|---|
| Provider Type | Practitioner - Peripheral Vascular Disease |
| Provider Identifiers | NPI Number: 1972609949 PECOS PAC ID: 9638113947 Enrollment ID: I20061101000273 |
| Provider Name | Cathy L Baldwin Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780699264 PECOS PAC ID: 4981781473 Enrollment ID: I20080408000670 |
| Provider Name | Lawrence J Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205890092 PECOS PAC ID: 7719921527 Enrollment ID: I20080714000692 |
| Provider Name | Jerry R Tanner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962580480 PECOS PAC ID: 8224020045 Enrollment ID: I20081023000349 |
| Provider Name | Carson S Webb |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1053491019 PECOS PAC ID: 0143255042 Enrollment ID: I20090114000168 |
| Provider Name | Heather E Brock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992712442 PECOS PAC ID: 4183780505 Enrollment ID: I20090309000646 |
| Provider Name | Rebecca J Bingham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093724270 PECOS PAC ID: 7416139530 Enrollment ID: I20110310000901 |
| Provider Name | Kimberly Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922234343 PECOS PAC ID: 0345395778 Enrollment ID: I20111028000644 |
| Provider Name | Yiming Wu |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1225248669 PECOS PAC ID: 5395984173 Enrollment ID: I20130627000309 |
| Provider Name | Scott Allan Ebenhoeh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679705784 PECOS PAC ID: 2163645912 Enrollment ID: I20150622000711 |
| Provider Name | Stacy L Brunquist |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104059492 PECOS PAC ID: 9739347717 Enrollment ID: I20160229002850 |
| Provider Name | Mark E Willcox |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1336395599 PECOS PAC ID: 4183817034 Enrollment ID: I20160812000443 |
| Provider Name | Terin Ostroski |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154663680 PECOS PAC ID: 9830316660 Enrollment ID: I20161129000162 |
| Provider Name | Gene R Quinn |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1194052944 PECOS PAC ID: 3274780416 Enrollment ID: I20170615000843 |
| Provider Name | Jacob P Kelly |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1851551949 PECOS PAC ID: 2567630015 Enrollment ID: I20170725002881 |
| Provider Name | Lisa Lindquist |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114278363 PECOS PAC ID: 7416172861 Enrollment ID: I20170817002496 |
| Provider Name | Clifford C Ellingson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922360619 PECOS PAC ID: 4981992948 Enrollment ID: I20170919002085 |
| Provider Name | Tracie Ann Panting |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841795952 PECOS PAC ID: 6901169325 Enrollment ID: I20180418001490 |
| Provider Name | Laura Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588163794 PECOS PAC ID: 4688938210 Enrollment ID: I20180508001611 |
| Provider Name | Mindy Leigh Goorchenko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871070375 PECOS PAC ID: 7012260052 Enrollment ID: I20181022001818 |
| Provider Name | Kevin M. Kollins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952563462 PECOS PAC ID: 5395932826 Enrollment ID: I20181128000226 |
| Provider Name | Louay Joseph Toni |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215057765 PECOS PAC ID: 4789991787 Enrollment ID: I20181206002946 |
| Provider Name | Kristerra N Yawea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154897429 PECOS PAC ID: 3971849365 Enrollment ID: I20190104002763 |
| Provider Name | Jeffrey Alan Conwell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518937978 PECOS PAC ID: 1052369261 Enrollment ID: I20190219003174 |
| Provider Name | Ahmed S Abuzaid |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437413895 PECOS PAC ID: 8820300486 Enrollment ID: I20190621001238 |
| Provider Name | Suneet Nitin Purohit |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1760781553 PECOS PAC ID: 8325262876 Enrollment ID: I20190906001379 |
| Provider Name | Ryan J Mcdonough |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1568635357 PECOS PAC ID: 7810165404 Enrollment ID: I20190918000358 |
| Provider Name | Cory Noel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952570418 PECOS PAC ID: 9234385642 Enrollment ID: I20191009000222 |
| Provider Name | Hung Nam Vo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1972923076 PECOS PAC ID: 3375760523 Enrollment ID: I20200722003115 |
| Provider Name | Blake Charlton |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1982946315 PECOS PAC ID: 0840582151 Enrollment ID: I20200806002009 |
| Provider Name | Herman H Feringa |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356597827 PECOS PAC ID: 7315164027 Enrollment ID: I20200818001764 |
| Provider Name | Ryan Wallace |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548695075 PECOS PAC ID: 2769703552 Enrollment ID: I20200917000602 |
| Provider Name | Eric Scott Anding |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1487649521 PECOS PAC ID: 0749259414 Enrollment ID: I20210216002548 |
| Provider Name | Melissa Ann Helen Fall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649856527 PECOS PAC ID: 7315355864 Enrollment ID: I20210421001970 |
| Provider Name | Jamie L Westenskow |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1134691009 PECOS PAC ID: 1759790587 Enrollment ID: I20210507001670 |
| Provider Name | Tara Rae Nagel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982958799 PECOS PAC ID: 0547690703 Enrollment ID: I20210602003406 |
| Provider Name | John C Stephens |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1043424765 PECOS PAC ID: 1153494869 Enrollment ID: I20210607003148 |
| Provider Name | Cynthia D Rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508818758 PECOS PAC ID: 1052571122 Enrollment ID: I20210610002855 |
| Provider Name | Anne-marie Boucher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790221190 PECOS PAC ID: 3173808862 Enrollment ID: I20210809003117 |
| Provider Name | Jeanne R Parrish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801223151 PECOS PAC ID: 8224265533 Enrollment ID: I20210921003413 |
| Provider Name | William Edward Trawick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437106796 PECOS PAC ID: 3274925011 Enrollment ID: I20220127002761 |
| Provider Name | Sara Gergen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679666309 PECOS PAC ID: 0143479154 Enrollment ID: I20220209002436 |
| Provider Name | Warren Cole Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730833542 PECOS PAC ID: 7012302458 Enrollment ID: I20220321002534 |
| Provider Name | Mark Landon Millwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437725058 PECOS PAC ID: 8527445287 Enrollment ID: I20220518001435 |
| Provider Name | Ann Olack |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1184963027 PECOS PAC ID: 0345488805 Enrollment ID: I20220523001034 |
| Provider Name | Jeffrey Alexander Dixson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386968808 PECOS PAC ID: 8921352626 Enrollment ID: I20220721001228 |
| Provider Name | Samantha Pasiewicz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720737083 PECOS PAC ID: 5991188641 Enrollment ID: I20220813000656 |
| Provider Name | Seth Workentine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164043014 PECOS PAC ID: 1456776954 Enrollment ID: I20230726001633 |
| Provider Name | Nelly Ayala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336625771 PECOS PAC ID: 8123489481 Enrollment ID: I20230802003166 |
| Provider Name | David Mendez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194188359 PECOS PAC ID: 2769774470 Enrollment ID: I20230816002942 |
| Provider Name | Marianne Ziolkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134843840 PECOS PAC ID: 2264894674 Enrollment ID: I20230817000960 |
| Provider Name | Jasleen Tiwana |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1922411685 PECOS PAC ID: 9133423239 Enrollment ID: I20230918001067 |
| Provider Name | Monica Loht |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881121317 PECOS PAC ID: 4981055134 Enrollment ID: I20240111003777 |
| Provider Name | Bradley R Dayton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790126035 PECOS PAC ID: 3173987948 Enrollment ID: I20240123002065 |
Compass Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1236 G St, Anchorage, AK 99501 Phone: 907-317-7136 | |
Buckingham Psychological Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2401 E 42nd Ave Ste 306, Anchorage, AK 99508 Phone: 907-744-1882 | |
Jillanne Garrity Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 8721 Kathleen Dr, Anchorage, AK 99502 Phone: 907-312-4448 | |
Sealing Cove Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 N St Ste 102, Anchorage, AK 99501 Phone: 907-312-5564 | |
Frontier Health Services, P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4241 B Street, Suite 305, Anchorage, AK 99503 Phone: 907-222-6688 Fax: 800-556-6916 | |
Building Blocks Academy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3327 Fairbanks St, Anchorage, AK 99503 Phone: 907-331-8598 | |
Volunteers Of America Alaska, Russian Jack Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4300 E 20th Ave, Anchorage, AK 99508 Phone: 907-279-9640 |