Shannon Lee Ruth Dieffenderfer, in Anchorage, AK

Shannon Lee Ruth Dieffenderfer, is a medicare enrolled "Physician Assistant" in Anchorage, Alaska. She went to Philadelphia Col Of Osteo Med, Sewanee and graduated in 2020 and has 5 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Tanana Valley Clinic Llc and her current practice location is 4100 Lake Otis Pkwy Ste 108, Anchorage, Alaska. You can reach out to her office (for appointments etc.) via phone at (907) 563-3145.

Shannon Lee Ruth Dieffenderfer is licensed to practice in Alaska (license number 172156) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1861048530.

Contact Information

	Shannon Lee Ruth Dieffenderfer,
	4100 Lake Otis Pkwy Ste 108, Anchorage, AK 99508-5230
	(907) 563-3145
	(907) 561-3967

Map and Direction

Provider's Profile

Full Name	Shannon Lee Ruth Dieffenderfer
Gender	Female
Speciality	Physician Assistant
Experience	5 Years
Location	4100 Lake Otis Pkwy Ste 108, Anchorage, Alaska
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Shannon Lee Ruth Dieffenderfer attended and graduated from Philadelphia Col Of Osteo Med, Sewanee in 2020

NPI Data:

NPI Number: 1861048530
Provider Enumeration Date: 08/17/2019
Last Update Date: 06/06/2022

Medicare PECOS Information:

PECOS PAC ID: 9032526272
Enrollment ID: I20210505003147

Medical Identifiers

Medical identifiers for Shannon Lee Ruth Dieffenderfer such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1861048530	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	10117 (Georgia)	Secondary
390200000X	Student In An Organized Health Care Education/training Program	(Georgia)	Secondary
363A00000X	Physician Assistant	172156 (Alaska)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Fairbanks Memorial Hospital	Fairbanks, AK	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Tanana Valley Clinic Llc	5698056901	131

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shannon Lee Ruth Dieffenderfer is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Shannon Lee Ruth Dieffenderfer, 4100 Lake Otis Pkwy Ste 108, Anchorage, AK 99508-5230 Ph: (907) 563-3145	Shannon Lee Ruth Dieffenderfer, 4100 Lake Otis Pkwy Ste 108, Anchorage, AK 99508-5230 Ph: (907) 563-3145

Reviews and Comments

Physician Assistant Nurses in Anchorage, AK

Amanda Loomis, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 550 W 7th Ave Ste 1800, Anchorage, AK 99501 Phone: 907-269-7300
Bryan Farthing, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3841 Piper St, Suite T4-054, Anchorage, AK 99508 Phone: 907-562-6228
Kimberley Turner, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1400 E 4th Ave, Anchorage, AK 99501 Phone: 907-269-4234 Fax: 907-269-4235
Cynthia Nichols, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4100 Lake Otis Pkwy Ste 220, Anchorage, AK 99508 Phone: 907-563-3145
Corinne Faye Olivera, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 5005 Raspberry Rd, Building 9, Anchorage, AK 99502 Phone: 907-249-1276 Fax: 907-249-1145
Mark Andrew Malzahn, P.A.-C. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4100 Lake Otis Pkwy, #302, Anchorage, AK 99508 Phone: 907-563-7072 Fax: 907-562-5742
Mrs. Cynthia Jean Smith, PC-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3801 Lake Otis Pkwy, Anchorage, AK 99508 Phone: 907-562-2277

Shannon Lee Ruth Dieffenderfer, - Medicare Physician Assistant in Anchorage, AK