Myra Dimitrov Dimitrov, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

125163 Issued in AK

Practice address

2323 S Trunk Rd Apt 6
Palmer, AK 99645

Phone

(907) 746-6644

NPI assigned

Apr 15, 2014

Last updated

Nov 8, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Michigan State University College of Human Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bristol Bay Area Health CorporationGroup PAC ID 5890699920, 114 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bristol Bay Dba Kanakanak Hospital Hospital, Dillingham, AK, CCN 021309

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/17479dfb-b021-49d0-9c8a-9247a410a2a3/

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.

• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Aleknagik North, AK
  • NPI 1235291246

  TX

  Medicare reassignment Care Compare group NPD
• Arctic Slope Native Association LTD

  dba Sammuel Simmonds Memorial Hospital

  • Critical Access Hospital
  • Barrow, AK
  • NPI 1306933643
  Medicare reassignment NPD
• Southeast Alaska Regional Health Consortium

  dba Thorne Bay Health Clinic

  • Clinic/Center
  • Thorne Bay, AK
  • NPI 1376758037

  TX

  Medicare reassignment NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Koliganek, AK
  • NPI 1013079607
  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Ekwok, AK
  • NPI 1104988799
  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Pilot Point, AK
  • NPI 1174683825
  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Platinum, AK
  • NPI 1285796870
  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Levelock, AK
  • NPI 1366502767
  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • South Naknek, AK
  • NPI 1417018193
  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Twin Hills, AK
  • NPI 1487716825
  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Perryville, AK
  • NPI 1528128782
  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Chignik Lagoon, AK
  • NPI 1578623641
  NPD

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

• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Togiak, AK
  • NPI 1093877680

  Hospital

  Care Compare affiliation
• Bristol Bay Area Health Corporation

  • Critical Access Hospital
  • Dillingham, AK
  • NPI 1831270842
  Care Compare affiliation
• Bristol Bay Area Health Corporation

  • Critical Access Hospital
  • Dillingham, AK
  • NPI 1962688309
  Care Compare affiliation

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1134548464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 S TRUNK RD APT 6",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996455940",
            "telephone_number": "907-746-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 S TRUNK RD APT 6",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "99645",
            "telephone_number": "907-746-6644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 W 5th Ave",
            "address_2": "STE 200W",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992044880",
            "country_code": "US",
            "telephone_number": "509-624-2313",
            "fax_number": "509-459-0686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIMITROV",
        "first_name": "MYRA",
        "middle_name": "DIMITROV",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "125163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandrea Dennison
• Guylene Derry
• Jacob Christopher Dewey
• Sara Jean Diamond
• Christopher David Dietrich, PA-C
• Tatyana Disla
• Bailey Ditmer, LMT
• Polly Anderson Divens
• Division of Alaskan Pioneer Homes
• Elizabeth Ann Dixon

• Family Medicine Physician in Palmer, AK
• Providers in Palmer, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; 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.

Verify at the official NPI Registry.