Aleutian Pribilof Islands Association, Inc
Organization Active NPI Community Health Clinic/Center · St. George, AK
NPI 1013079755 · NPPES record last updated Jan 23, 2014
Key facts
- NPI
- 1013079755
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Health Clinic/Center 261QC1500X
- Legal business name
- ALEUTIAN PRIBILOF ISLANDS ASSOCIATION, INC
- Practice address
- 934 Main Street
St. George, AK 99591 - Phone
- (907) 859-2254
- Fax
- (907) 859-2252
- NPI assigned
- Dec 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Dimitri Philemonof
- Title
- President/Ceo
- Phone
- (907) 276-2700
Other NPIs on the same Medicare enrollment 13
Practitioners 6
-
Elizabeth Clare Graham, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AK, TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040331000995 | AK | Part B Supplier - Clinic/Group Practice | 2860301884 |
Receives reassigned benefits from 19 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Adak, AK; Whittier, AK; Sand Point, AK; Nelson Lagoon, AK; False Pass, AK; Cold Bay, AK; Akutan, AK; King Cove, AK |
| O20140225001523 | TX | Part B Supplier - Clinic/Group Practice | 0648310656 |
Receives reassigned benefits from 34 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Anchorage, AK; Atka, AK; Nikolski, AK; St George Island, AK; Unalaska, AK |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker |
172V00000X | |||
| Community Health Clinic/Center | 261QC1500X | AK | ||
| Community Health Clinic/Center | 261QC1500X | Yes |
Addresses
Primary practice location
934 Main Street
St. George, AK 99591
Mailing address
1131 E. International Airport Rd
Anchorage, AK 99518
Phone (907) 276-2700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CL0005 | Medicaid | AK | |
| CLOOO5 | Medicaid | AK |
Other providers in St. George, AK
All providers in St. George, AK · Community Health Clinic/Center in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.