Active NPI
Elena Larranaga, PA-C
- Physician Assistant
- Fairbanks, AK
National Provider Identifier
1114391968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 104338
- Practice address
- 1717 W Cowles St
Fairbanks, AK 99701-5926 - Phone
- (907) 451-6682
- Fax
- (907) 459-3811
- NPI assigned
- Nov 17, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 104338 | AK | Primary |
Addresses
Primary practice location
1717 W Cowles St
Fairbanks, AK 99701-5926
Mailing address
1717 W Cowles St
Fairbanks, AK 99701-5926
Phone (907) 451-6682
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1717 W Cowles St
Fairbanks, AK 99701-5926
Phone (907) 451-6682
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104338 | AK | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tanana Chiefs Conference | Current | Accepting new patients |
Locations
1717 W Cowles St
Fairbanks, AK 99701
Phone (907) 452-6682
Interoperability endpoints
- elena.larranaga.1@15989.direct.athenahealth.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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618876800000",
"number": "1114391968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 W COWLES ST",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997015926",
"telephone_number": "907-451-6682",
"fax_number": "907-459-3811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 W COWLES ST",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997015926",
"telephone_number": "907-451-6682",
"fax_number": "907-459-3811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARRANAGA",
"first_name": "ELENA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-17",
"last_updated": "2021-04-20",
"certification_date": "2021-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AK",
"license": "104338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.