NPIMap

Individual provider Active NPI

Jefferson Wasson, DO

  • Family Medicine Physician
  • Kenai, AK
National Provider Identifier
1043771207
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
189244 Issued in AK
Practice address
506 Lake St
Kenai, AK 99611-6937
Phone
(907) 714-4025
Fax
(844) 412-3952
NPI assigned
Mar 28, 2019
Last updated
Oct 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 189244 AK Primary

Addresses

Primary practice location

506 Lake St
Kenai, AK 99611-6937

Mailing address

250 Hospital PL
Soldotna, AK 99669-6999
Phone (907) 714-4038

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwasson2595082@ak.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221217000181 AK Practitioner - Family Practice 9830568690 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un Col of Osteopathic Medicine, New York, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

506 Lake St
Kenai, AK 99611-6937
Phone (907) 714-4025

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.44 of 100Reported as group
Quality
62.56
Promoting interoperability
81
Improvement activities
40
Cost
67.88

Merit-based Incentive Payment System (MIPS)

Final score
70.59 of 100Reported as group
Quality
83.37
Promoting interoperability
100
Improvement activities
40
Cost
16.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions12
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Central Peninsula General Hospital, Inc CurrentSince Apr 7, 2024 Accepting new patients
North Star Medical Imaging PLLC Current Accepting new patients
Central Peninsula General Hospital, Inc CurrentSince Apr 7, 2024 Accepting new patients
Medical Network of Alaska, LLC Current Accepting new patients
Central Peninsula General Hospital Inc. Current Accepting new patients
Medical Network of Alaska, LLC Current Accepting new patients
Medical Network of Alaska, LLC CurrentSince Sep 9, 2022 Accepting new patients
Medical Network of Alaska, LLC CurrentSince Sep 9, 2022 Accepting new patients
Central Peninsula General Hospital Inc Past Accepting new patients
Central Peninsula General Hospital Inc Past Accepting new patients

Locations

10543 Kenai Spur Hwy
Kenai, AK 99611
Phone (907) 283-9118

506 Lake St
Kenai, AK 99611
Phone (907) 714-4025

250 Hospital Pl
Soldotna, AK 99669
Phone (907) 714-4404

3122 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 864-4625

3331 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 357-2332

Interoperability endpoints

  • Direct secure messaging: jwasson2595082@ak.providencedirect.org

Organizations & group practices 10

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.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1043771207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 HOSPITAL PL",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996696999",
            "telephone_number": "907-714-4038",
            "fax_number": "907-262-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 LAKE ST",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996116937",
            "telephone_number": "907-714-4025",
            "fax_number": "844-412-3952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSON",
        "first_name": "JEFFERSON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-28",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "189244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwasson2595082@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "506 Lake St",
            "city": "Kenai",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996116937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kenai, AK

Sources for this page

Verify at the official NPI Registry.