Individual provider Active NPI

Susan Hartmann, PA-C

  • Surgical Physician Assistant
  • Anchorage, AK
National Provider Identifier
1104555408
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
199396 Issued in AK
Practice address
301 W Northern Lights Blvd Ste 400
Anchorage, AK 99503-2648
Phone
(907) 563-4810
Fax
(907) 563-4811
NPI assigned
Jun 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 199396 AK Primary

Addresses

Primary practice location

301 W Northern Lights Blvd Ste 400
Anchorage, AK 99503-2648

Mailing address

301 W Northern Lights Blvd Ste 400
Anchorage, AK 99503-2648
Phone (907) 563-4810

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
I20230228000995 AK Practitioner - Physician Assistant 2062885759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, 1,992 clinicians
Coastal Neurology and Neurosurgery IncGroup PAC ID 9436303427, 10 clinicians

Practice addresses (Care Compare)

10928 Eagle River Rd
Suite 150
Eagle River, AK 99577-8078
Phone (907) 694-8085

1700 E Bogard Rd
Suite B203
Wasilla, AK 99654-6570
Phone (907) 921-5088

3719 E Meridian Loop
Suite E
Wasilla, AK 99654-7273
Phone (907) 563-4810

Hospital & facility affiliations

  • Alaska Regional Hospital Hospital, Anchorage, AK, CCN 020017
  • Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001
  • Providence Kodiak Island Medical Ctr Hospital, Kodiak, AK, CCN 021306

Merit-based Incentive Payment System (MIPS)

Final score
70.59 of 100Reported as group
Quality
83.37
Promoting interoperability
100
Improvement activities
40
Cost
16.65

National Provider Directory

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

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1104555408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W NORTHERN LIGHTS BLVD STE 400",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032648",
            "telephone_number": "907-563-4810",
            "fax_number": "907-563-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W NORTHERN LIGHTS BLVD STE 400",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032648",
            "telephone_number": "907-563-4810",
            "fax_number": "907-563-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMANN",
        "first_name": "SUSAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AK",
            "license": "199396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.