NPIMap

Individual provider Active NPI

Jeremy J Gitomer, M.D.

  • Nephrology Physician
  • Anchorage, AK
National Provider Identifier
1073509063
Registry record updated Jun 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
5028 Issued in AK
Practice address
4015 Lake Otis Pkwy
Suite 101
Anchorage, AK 99508-5211
Phone
(907) 375-5200
Fax
(907) 375-5201
NPI assigned
Sep 23, 2005
Last updated
Jun 19, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 5028 AK Primary

Addresses

Primary practice location

4015 Lake Otis Pkwy
Suite 101
Anchorage, AK 99508-5211

Mailing address

PO Box 196800
Anchorage, AK 99519-6800
Phone (907) 375-5200

Other identifiers 1

IdentifierTypeStateIssuer
1017876MedicaidAK

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
I20040416000025 AK Practitioner - NephrologyPractitioner - Internal Medicine 9537053392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Texas Medical School at Houston, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dialysis Associates of Alaska, LLCGroup PAC ID 1456345123, 13 clinicians
Kidney and Hypertension Clinic of Alaska IncGroup PAC ID 0840299186, 14 clinicians

Practice addresses (Care Compare)

3260 Providence Dr
Suite C431
Anchorage, AK 99508-4661
Phone (907) 212-4840

4015 Lake Otis Pkwy
Suite 201
Anchorage, AK 99508-5235
Phone (907) 375-5200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5028AKMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dialysis Associates of Alaska, LLC Nephrology CurrentSince Jan 1, 2004 Accepting new patients
Kidney and Hypertension Clinic of Alaska, Inc Nephrology CurrentSince Oct 1, 2006 Accepting new patients
Transtreme, LLC Past Accepting new patients
Nephrology & Hypertension Associates of Alaska, PC Nephrology Past Accepting new patients
Alaska Kidney Consultants Nephrology Past Accepting new patients
Aurora Kidney LLC Nephrology Past Accepting new patients
Swedish Health Services Past Accepting new patients
Kidney and Hypertension Clinic of Alaska LLC Nephrology Past Accepting new patients

Locations

3260 Providence Dr
#326
Anchorage, AK 99508
Phone (907) 562-2712

3260 Providence Dr
Ste C431
Anchorage, AK 99508
Phone (907) 212-4840

3300 Providence Dr
Ste 304
Anchorage, AK 99508
Phone (907) 212-4840

3300 Providence Dr
Ste B2
Anchorage, AK 99508

4015 Lake Otis Pkwy
Ste 101
Anchorage, AK 99508

4015 Lake Otis Pkwy
Ste 201
Anchorage, AK 99508
Phone (907) 771-3500

901 E Dimond Blvd
Ste G
Anchorage, AK 99515
Phone (907) 522-9009

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14795/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/22880/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jeremy.gitomer.1@14795.direct.athenahealth.com
  • Direct secure messaging: jeremy.gitomer.1@22880.direct.athenahealth.com

Organizations & group practices 8

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 5

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1073509063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 196800",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995196800",
            "telephone_number": "907-375-5200",
            "fax_number": "907-375-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 LAKE OTIS PKWY",
            "address_2": "SUITE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085211",
            "telephone_number": "907-375-5200",
            "fax_number": "907-375-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GITOMER",
        "first_name": "JEREMY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AK",
            "license": "5028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017876",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.