NPIMap

Individual provider Active NPI

Mark Victor Restad, PA-C

  • Physician Assistant
  • Kenai, AK
National Provider Identifier
1114145174
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
344 Issued in AK
Practice address
11472 Kenai Spur Hwy
Suite #2
Kenai, AK 99611-7756
Phone
(907) 283-6030
Fax
(907) 283-3194
NPI assigned
Apr 23, 2007
Last updated
May 21, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 344 AK Primary

Addresses

Primary practice location

11472 Kenai Spur Hwy
Suite #2
Kenai, AK 99611-7756

Mailing address

11472 Kenai Spur Hwy
Suite #2
Kenai, AK 99611-7756
Phone (907) 283-6030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110811000844 AK Practitioner - Physician Assistant 6406025287 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Redoubt Medical Group LLC.Group PAC ID 2961898366, 4 clinicians
Anchorage Sleep Center LLCGroup PAC ID 5890964746, 11 clinicians

Practice addresses (Care Compare)

130 S Willow St
Suite 1
Kenai, AK 99611-9107
Phone (907) 283-6030

323 W Danview Ave
Homer, AK 99603-7028
Phone (907) 235-7000

510 W Tudor Rd
Suite 5
Anchorage, AK 99503-6649
Phone (907) 743-0050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.2 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
74

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anchorage Sleep Center, LLC Dba Fairbanks Sleep Center CurrentSince Oct 9, 2020 Accepting new patients
Kenneth S Hahn Past Accepting new patients

Locations

510 W Tudor Rd
Ste 5
Anchorage, AK 99503
Phone (907) 743-0050

323 W Danview Ave
Ste 201
Homer, AK 99603
Phone (907) 235-7000

Organizations & group practices 4

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 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1114145174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11472 KENAI SPUR HWY",
            "address_2": "SUITE #2",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117756",
            "telephone_number": "907-283-6030",
            "fax_number": "907-283-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11472 KENAI SPUR HWY",
            "address_2": "SUITE #2",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117756",
            "telephone_number": "907-283-6030",
            "fax_number": "907-283-3194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESTAD",
        "first_name": "MARK",
        "middle_name": "VICTOR",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenai, AK

Sources for this page

Verify at the official NPI Registry.