Organization Active NPI

Katieostrommd

Doing business as Katie Ostrom MD, LLC

  • Obstetrics & Gynecology Physician
  • Homer, AK
National Provider Identifier
1093352502
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
KATIEOSTROMMD
Doing business as
Katie Ostrom MD, LLC
Practice address
4129 Bartlett St
Homer, AK 99603-7002
Phone
(907) 435-0555
Fax
(833) 992-2172
NPI assigned
Dec 3, 2019
Last updated
May 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Authorized official

Name
Pamela Cross
Title
Office Manager
Phone
(907) 921-2307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

4129 Bartlett St
Homer, AK 99603-7002

Mailing address

205 W Fairview
Homer, AK 99603
Phone (907) 435-0555

Other practice location 1

35670 Kenai Spur Hwy Ste 103A
Soldotna, AK 99669-7649
Phone (907) 435-0555

Other identifiers 2

IdentifierTypeStateIssuer
1702227MedicaidAK
1007494MedicaidAK

Other names 1

  • Katie Ostrom MD, LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200403002924 AK Part B Supplier - Clinic/Group Practice 2062841554 Receives reassigned benefits from 2 practitioners
Practice locations: Homer, AK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
02D2176366Katieostrommd, LLC4129 Bartlett Street, Homer, AK 99603Provider-performed microscopyDec 11, 2027

National Provider Directory

National Provider Directory

Locations

205 W Fairview Ave
Homer, AK 99603
Phone (907) 226-5600

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746403200000",
    "number": "1093352502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W FAIRVIEW",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "99603",
            "telephone_number": "907-435-0555",
            "fax_number": "907-435-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4129 BARTLETT ST",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037002",
            "telephone_number": "907-435-0555",
            "fax_number": "833-992-2172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35670 Kenai Spur Hwy Ste 103A",
            "address_purpose": "LOCATION",
            "city": "Soldotna",
            "state": "AK",
            "postal_code": "996697649",
            "country_code": "US",
            "telephone_number": "907-435-0555",
            "fax_number": "833-992-2172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KATIEOSTROMMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-03",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "907-921-2307"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1702227",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007494",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Katie Ostrom MD, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Katie Ostrom MD, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Homer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.