Jessica Dionela Petalio, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

216124 Issued in AK

Practice address

4951 Business Park Blvd
Anchorage, AK 99503-7174

Phone

(907) 743-7200

NPI assigned

Nov 8, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anchorage Neighborhood Health Center IncGroup PAC ID 0941107288, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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

• Anchorage Neighborhood Health Center Inc

  • Family Medicine Physician
  • Anchorage, AK
  • NPI 1811170210
  Medicare reassignment Care Compare group NPD
• Anchorage Neighborhood Health Center, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Anchorage, AK
  • NPI 1184367195
  NPD

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1063286318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 BUSINESS PARK BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 BUSINESS PARK BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037174",
            "telephone_number": "907-743-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETALIO",
        "first_name": "JESSICA",
        "middle_name": "DIONELA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AK",
            "license": "216124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Raymond Pervier, M.D.
• Paneti Leveni Pese
• Vavega Peseti
• Noellinda Christy Pesio
• Britani Peska
• Pete B. Higgins DDS LLC
• Peter D Marbarger MD Apc
• Peter D Riley MD
• Alexandra Arin Peter
• Colin Mark Peter

• Clinical Psychologist in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Clinical Psychologist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.