NPIMap

Organization Active NPI

Alyeska Trauma & Acute General Surgery LLC

  • Surgery Physician
  • Anchorage, AK
National Provider Identifier
1104517192
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ALYESKA TRAUMA & ACUTE GENERAL SURGERY LLC
Practice address
4001 Laurel St Ste 205
Anchorage, AK 99508-5300
Phone
(907) 562-8346
NPI assigned
May 19, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Authorized official

Name
Cinderella Tollefsen
Title
Ceo
Phone
(907) 865-5252

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary
Trauma Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0127X

Addresses

Primary practice location

4001 Laurel St Ste 205
Anchorage, AK 99508-5300

Mailing address

PO Box 220774
Anchorage, AK 99522-0774

Other names 1

  • ATAGS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230913003689 AK Part B Supplier - Clinic/Group Practice 9032573712 Receives reassigned benefits from 11 practitioners
Practice locations: Anchorage, AK

National Provider Directory

National Provider Directory

Locations

4001 Laurel St
Ste 205
Anchorage, AK 99508
Phone (907) 561-1434

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1104517192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220774",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995220774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 LAUREL ST STE 205",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085300",
            "telephone_number": "907-562-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALYESKA TRAUMA & ACUTE GENERAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-19",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "TOLLEFSEN",
        "authorized_official_first_name": "CINDERELLA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-865-5252"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATAGS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ATAGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.