Active NPI
John E. Varallo, MD, MPH
- Obstetrics & Gynecology Physician
- Ketchikan, AK
National Provider Identifier
1104860261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 6136
- Practice address
- 3100 Tongass Ave
Ketchikan, AK 99901-5746 - Phone
- (907) 228-8300
- Fax
- (907) 228-8518
- NPI assigned
- Jun 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MD21361 | DC | |
| Obstetrics & Gynecology Physician | 207V00000X | 6136 | AK | Primary |
Addresses
Primary practice location
3100 Tongass Ave
Ketchikan, AK 99901-5746
Mailing address
3100 Tongass Ave
Ketchikan, AK 99901-5746
Phone (907) 228-8300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104410 | Medicaid | AZ | |
| MD4127 | Medicaid | AK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 79.12 of 100
- Quality
- 81.91
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 40.93
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192147200000",
"number": "1104860261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 TONGASS AVE",
"city": "KETCHIKAN",
"state": "AK",
"postal_code": "999015746",
"telephone_number": "907-228-8300",
"fax_number": "907-228-8518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 TONGASS AVE",
"city": "KETCHIKAN",
"state": "AK",
"postal_code": "999015746",
"telephone_number": "907-228-8300",
"fax_number": "907-228-8518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARALLO",
"first_name": "JOHN",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "MD, MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-16",
"last_updated": "2007-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "DC",
"license": "MD21361",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "AK",
"license": "6136",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104410",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MD4127",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ketchikan, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.