Individual provider Active NPI

David L Barnes, D.O.

  • Internal Medicine Physician
  • Wasilla, AK
National Provider Identifier
1124081211
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2640 Issued in AK
Practice address
3719 E Meridian Loop Ste a
Wasilla, AK 99654-7273
Phone
(907) 376-2868
Fax
(907) 376-2811
NPI assigned
Apr 10, 2006
Last updated
Apr 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2640 AK Primary

Addresses

Primary practice location

3719 E Meridian Loop Ste a
Wasilla, AK 99654-7273

Mailing address

3719 E Meridian Loop Ste a
Wasilla, AK 99654-7273
Phone (907) 376-2868

Other identifiers 4

IdentifierTypeStateIssuer
050582551OtherAKTAX ID
MD2640MedicaidAK
DD1707OtherAKMEDICARE RAILROAD
610517800OtherAKDEPARTMENT OF LABOR

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260401000302 AK Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6305758640

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Texas Tech University Health Science Center School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2640AKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Critical Care & Pulmonary Consultants, PC PastSince Jul 1, 2002 Accepting new patients
Mat-Su Valley Medical Center LLC Past Accepting new patients
Philippe G Lopez MD PC PastSince Jun 16, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEBCBD/Endpoint/DEBCBD

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.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1124081211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 E MERIDIAN LOOP STE A",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547273",
            "telephone_number": "907-376-2868",
            "fax_number": "907-376-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3719 E MERIDIAN LOOP STE A",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547273",
            "telephone_number": "907-376-2868",
            "fax_number": "907-376-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "2640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "050582551",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD2640",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DD1707",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "610517800",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.