Individual provider Active NPI

John Oliver, M.D.

  • Gynecology Physician
  • Wasilla, AK
National Provider Identifier
1093778029
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
4950 Issued in AK
Practice address
3750 E Country Field Cir Ste D
Wasilla, AK 99654-6659
Phone
(907) 357-6121
Fax
(907) 357-6171
NPI assigned
Apr 10, 2006
Last updated
Jul 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 4950 AK Primary

Addresses

Primary practice location

3750 E Country Field Cir Ste D
Wasilla, AK 99654-6659

Mailing address

PO Box 871988
Wasilla, AK 99687-1988
Phone (907) 357-6121

Other identifiers 3

IdentifierTypeStateIssuer
160059561OtherAKMEDICARE RAILROAD
954332081OtherAKTAX ID
MD5356MedicaidAK

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050826000754 AK Practitioner - Obstetrics/Gynecology 8022049295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Loma Linda University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John R Oliver MD PCGroup PAC ID 4981704400, 2 clinicians

Practice addresses (Care Compare)

3750 E Country Field Cir
Suite D
Wasilla, AK 99654-6659
Phone (907) 357-6121

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4950AKMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
John R Oliver MD Inc Gynecology CurrentSince Mar 7, 2007 Accepting new patients

Locations

3750 E Country Field Cir
Ste D
Wasilla, AK 99654
Phone (907) 357-6121

950 E Bogard Rd
Ste 238
Wasilla, AK 99654
Phone (907) 357-1917

Interoperability endpoints

  • Direct secure messaging: johnolivermd@141156.advancedmd-direct.com

Organizations & group practices 1

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 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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1093778029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 871988",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996871988",
            "telephone_number": "907-357-6121",
            "fax_number": "907-357-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 E COUNTRY FIELD CIR STE D",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546659",
            "telephone_number": "907-357-6121",
            "fax_number": "907-357-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "AK",
            "license": "4950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "160059561",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "954332081",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD5356",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.