Individual provider Active NPI

Amy Lynn Sauck, DPT

  • Physical Therapist
  • Wasilla, AK
National Provider Identifier
1003076571
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2689 Issued in AK
Practice address
1700 E Bogard Rd
Suite B203
Wasilla, AK 99654-6563
Phone
(907) 376-4325
NPI assigned
Jun 9, 2008
Last updated
Jun 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8213 MN
Physical Therapist 225100000X 2689 AK Primary

Addresses

Primary practice location

1700 E Bogard Rd
Suite B203
Wasilla, AK 99654-6563

Mailing address

1700 E Bogard Rd
Suite B203
Wasilla, AK 99654-6563
Phone (907) 376-4325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140926002289 AK Practitioner - Physical Therapist in Private Practice 9032339940 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, 1,992 clinicians

Practice addresses (Care Compare)

1700 E Bogard Rd
Suite B203
Wasilla, AK 99654-6570
Phone (907) 921-5088

33455 Sterling Hwy
Sterling, AK 99672-9200
Phone (907) 262-7748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2689AKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Holdings Inc CurrentSince Apr 28, 2022 Accepting new patients
Matt a. Heilala, DPM Inc. CurrentSince Feb 14, 2023 Accepting new patients
Select Physical Therapy Holdings Inc Physical Therapist CurrentSince Apr 28, 2022 Accepting new patients
Matt a. Heilala, DPM Inc. CurrentSince Feb 14, 2023 Accepting new patients

Locations

2250 E 42nd Ave
#200
Anchorage, AK 99508
Phone (907) 569-3668

1700 E Bogard Rd
Ste B203
Wasilla, AK 99654
Phone (907) 376-4325

3190 E Meridian Park Loop
Ste 205
Wasilla, AK 99654
Phone (907) 373-3338

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21331/brand/1/csg/1/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1003076571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E BOGARD RD",
            "address_2": "SUITE B203",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546563",
            "telephone_number": "907-376-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E BOGARD RD",
            "address_2": "SUITE B203",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546563",
            "telephone_number": "907-376-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUCK",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8213",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "2689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.