Individual provider Active NPI

Jodee Lynn Deutsch Trivette, PA-C

  • Physician Assistant
  • Fairbanks, AK
National Provider Identifier
1063764504
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1650 Cowles St
Fairbanks, AK 99701-5999
Phone
(907) 458-6943
NPI assigned
Oct 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1650 Cowles St
Fairbanks, AK 99701-5999

Mailing address

1650 Cowles St
Fairbanks, AK 99701-5999
Phone (907) 458-6943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121213000485 AK Practitioner - Physician Assistant 0648422964 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tanana Valley Clinic LLCGroup PAC ID 5698056901, 142 clinicians

Practice addresses (Care Compare)

1001 Noble St
Fairbanks, AK 99701-4948
Phone (907) 459-3500

Hospital & facility affiliations

  • Fairbanks Memorial Hospital Hospital, Fairbanks, AK, CCN 020012

Merit-based Incentive Payment System (MIPS)

Final score
92.86 of 100Reported as group
Quality
94.88
Promoting interoperability
100
Improvement activities
40
Cost
79.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tanana Valley Clinic LLC CurrentSince Nov 10, 2024 Accepting new patients
Tanana Valley Clinic LLC CurrentSince Nov 10, 2024 Accepting new patients

Locations

1919 Lathrop St
Ste 222
Fairbanks, AK 99701
Phone (907) 456-5990

1001 Noble St
Fairbanks, AK 99701
Phone (907) 276-2806

1650 Cowles St
Fairbanks, AK 99701
Phone (907) 452-8181

Interoperability endpoints

  • Direct secure messaging: jodee.trivette.p1@direct.tananavalley.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1063764504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015999",
            "telephone_number": "907-458-6943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015999",
            "telephone_number": "907-458-6943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIVETTE",
        "first_name": "JODEE",
        "middle_name": "LYNN DEUTSCH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.