| A4 Specialty Medical Group Llc | |
|
510 W Tudor Rd Ste 1 Anchorage AK 99503-6649 | |
| (907) 744-1944 | |
| (907) 921-7669 |
| Full Name | A4 Specialty Medical Group Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 510 W Tudor Rd Ste 1, Anchorage, Alaska |
| Authorized Official Name and Position | Lisa Bruce (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 9077441944 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A4 Specialty Medical Group Llc 510 W Tudor Rd Ste 1 Anchorage AK 99503-6649 Ph: (907) 744-1944 | A4 Specialty Medical Group Llc 510 W Tudor Rd Ste 1 Anchorage AK 99503-6649 Ph: (907) 744-1944 |
| NPI Number | 1659010361 |
|---|---|
| Provider Enumeration Date | 06/01/2022 |
| Last Update Date | 10/08/2025 |
| Medicare PECOS PAC ID | 7315313558 |
|---|---|
| Medicare Enrollment ID | O20221013000870 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659010361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Jeffrey G Demain |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1548201395 PECOS PAC ID: 7810989399 Enrollment ID: I20040706000728 |
| Provider Name | Melissa Van Fossen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235837865 PECOS PAC ID: 6204291792 Enrollment ID: I20230505002290 |
| Provider Name | Cielito Marie Bundang Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437921095 PECOS PAC ID: 9638528060 Enrollment ID: I20231212000051 |
| Provider Name | Melanie Wright Baldwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285474965 PECOS PAC ID: 1153844550 Enrollment ID: I20250326002418 |
Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3300 Fairbanks St Suite A, Anchorage, AK 99503 Phone: 907-561-3488 Fax: 907-562-3488 | |
Alaska Family Care Associates, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4001 Dale Street, Suite 210, Anchorage, AK 99508 Phone: 907-929-5888 Fax: 907-929-5882 | |
Daryl M. Mcclendon, M.d., P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3851 Piper St, Suite U466, Anchorage, AK 99508 Phone: 907-569-1333 Fax: 907-569-1433 | |
Willow Wellness Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3030 Wendys Way Unit A, Anchorage, AK 99517 Phone: 406-253-7924 | |
Autonomology, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2925 Debarr Rd Ste 240, Anchorage, AK 99508 Phone: 907-339-4657 | |
Douglas Carter Smith Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 17741 Mountainside Village Dr, Anchorage, AK 99516 Phone: 907-345-0728 Fax: 907-345-0728 | |
Internal Medicine Associates, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2841 Debarr Rd Ste 50, Anchorage, AK 99508 Phone: 907-276-2811 Fax: 907-276-2810 |