| 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 (ASSISTANT SECRETARY OF ENROLLMENTS) |
| Authorized Official Contact | 4253589786 |
| 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 | 05/14/2025 |
| Certification Date | 05/14/2025 |
| 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 | |
| MDG7982 | Medicaid | AK | |
| MDG798 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | () | Secondary |
| 282N00000X | General Acute Care Hospital | () | Primary |
| 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 | 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 | Lawrence J Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205890092 PECOS PAC ID: 7719921527 Enrollment ID: I20080714000692 |
| Provider Name | Carson S Webb |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1053491019 PECOS PAC ID: 0143255042 Enrollment ID: I20090114000168 |
| Provider Name | Marek a Martynowicz |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1962581249 PECOS PAC ID: 8729073093 Enrollment ID: I20091103000744 |
| Provider Name | Mary K Mccarty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003143363 PECOS PAC ID: 2163559279 Enrollment ID: I20100421000893 |
| Provider Name | Rebecca J Bingham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093724270 PECOS PAC ID: 7416139530 Enrollment ID: I20110310000901 |
| Provider Name | James Lee Christiansen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326080102 PECOS PAC ID: 5193906485 Enrollment ID: I20130130000285 |
| Provider Name | Even R Evanson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013285618 PECOS PAC ID: 3173761772 Enrollment ID: I20130521000025 |
| Provider Name | Yiming Wu |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1225248669 PECOS PAC ID: 5395984173 Enrollment ID: I20130627000309 |
| Provider Name | Will a Bemben |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1891082699 PECOS PAC ID: 7113170028 Enrollment ID: I20141030002049 |
| 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 | Mark E Willcox |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1336395599 PECOS PAC ID: 4183817034 Enrollment ID: I20160812000443 |
| 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 Patrick 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 | Louay Joseph Toni |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215057765 PECOS PAC ID: 4789991787 Enrollment ID: I20181206002946 |
| Provider Name | Jeffrey Alan Conwell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518937978 PECOS PAC ID: 1052369261 Enrollment ID: I20190219003174 |
| Provider Name | Lee Pierson |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1215103528 PECOS PAC ID: 3173836004 Enrollment ID: I20190520001029 |
| 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 | Cory Noel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952570418 PECOS PAC ID: 9234385642 Enrollment ID: I20191009000222 |
| Provider Name | Haley H Hughes |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1366950842 PECOS PAC ID: 4789948910 Enrollment ID: I20200331003657 |
| 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 | Tara Rae Nagel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982958799 PECOS PAC ID: 0547690703 Enrollment ID: I20210602003406 |
| Provider Name | John Stephens |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1043424765 PECOS PAC ID: 1153494869 Enrollment ID: I20210607003148 |
| Provider Name | Anne-marie Boucher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790221190 PECOS PAC ID: 3173808862 Enrollment ID: I20210809003117 |
| Provider Name | William Edward Trawick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437106796 PECOS PAC ID: 3274925011 Enrollment ID: I20220127002761 |
| Provider Name | Warren Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730833542 PECOS PAC ID: 7012302458 Enrollment ID: I20220321002534 |
| 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 | 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 - Addiction Medicine |
| 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 Dayton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790126035 PECOS PAC ID: 3173987948 Enrollment ID: I20240123002065 |
| Provider Name | Sean P Dugan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871721100 PECOS PAC ID: 0143486274 Enrollment ID: I20240329001548 |
| Provider Name | Betty K Anderson |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1942889613 PECOS PAC ID: 3870995335 Enrollment ID: I20240516001943 |
| Provider Name | Josiah Brown |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1043643430 PECOS PAC ID: 4284903402 Enrollment ID: I20240716001488 |
| Provider Name | Peter Fritz Alward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790001899 PECOS PAC ID: 7416494711 Enrollment ID: I20240805002099 |
| Provider Name | Marisa Rae Goldfinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699433888 PECOS PAC ID: 0042680357 Enrollment ID: I20240805003558 |
| Provider Name | Erin Mcneil Eisses |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1679291223 PECOS PAC ID: 8426594110 Enrollment ID: I20241025002233 |
| Provider Name | Rebecca Ervin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093300618 PECOS PAC ID: 1456760875 Enrollment ID: I20241211001445 |
| Provider Name | Linda Marie Bretey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336145655 PECOS PAC ID: 1456880582 Enrollment ID: I20250117002781 |
| Provider Name | Julie Ann Canales |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609457449 PECOS PAC ID: 5395263479 Enrollment ID: I20250513003352 |
| Provider Name | Edem Binka |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841532140 PECOS PAC ID: 2860781796 Enrollment ID: I20250602000990 |
| Provider Name | John Ahmad Yamin |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1942950159 PECOS PAC ID: 4183135825 Enrollment ID: I20250618002748 |
| Provider Name | Whitney W Wood |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1255072500 PECOS PAC ID: 3577943570 Enrollment ID: I20250626003918 |
| Provider Name | Matthew Studer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871702068 PECOS PAC ID: 2365686300 Enrollment ID: I20250716003608 |
| Provider Name | Graeme Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902795081 PECOS PAC ID: 0941700389 Enrollment ID: I20250821000786 |
| Provider Name | Jonathan Sheehan Schick |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1619668670 PECOS PAC ID: 4385145101 Enrollment ID: I20250902002693 |
| Provider Name | Kimberly C Harbison |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1235017054 PECOS PAC ID: 1355844333 Enrollment ID: I20250915001496 |
| Provider Name | Colleen Rose Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386093839 PECOS PAC ID: 8224513031 Enrollment ID: I20260330003646 |
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: Not Enrolled in Medicare Practice Location: 8721 Kathleen Dr, Anchorage, AK 99502 Phone: 907-312-4448 |
Angela Khessed Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 N St Ste 102, Anchorage, AK 99501 Phone: 479-653-1555 |
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 |