Individual provider Active NPI

Jared Robert Kirkham, M.D.

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Anchorage, AK
National Provider Identifier
1144544107
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
MEDS7978 Issued in AK
Practice address
4100 Lake Otis Pkwy Ste 108
Anchorage, AK 99508-5230
Phone
(907) 563-3145
Fax
(833) 464-5196
NPI assigned
Mar 19, 2010
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X MEDS7978 AK Primary

Addresses

Primary practice location

4100 Lake Otis Pkwy Ste 108
Anchorage, AK 99508-5230

Mailing address

4100 Lake Otis Pkwy Ste 108
Anchorage, AK 99508-5230
Phone (907) 563-3145

Other identifiers 1

IdentifierTypeStateIssuer
1610529MedicaidAK

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
I20140416002349 AK Practitioner - Physical Medicine and RehabilitationPractitioner - Sports Medicine 3779713128 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Sports Medicine
Education
University of Washington School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Anchorage Fracture and Orthopaedic Clinic PCGroup PAC ID 7517914187, 33 clinicians
Medical Network of Alaska LLCGroup PAC ID 3072618859, 70 clinicians

Practice addresses (Care Compare)

10928 Eagle River Rd
Suite 150
Eagle River, AK 99577-8078
Phone (907) 694-8085

12350 Industry Way
Suite 110
Anchorage, AK 99515-4301
Phone (907) 563-3145

4100 Lake Otis Pkwy
Anchorage, AK 99508-5230
Phone (907) 563-3145

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.73 of 100Reported as individual
Quality
40.78
Promoting interoperability
100
Improvement activities
40
Cost
78.31

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MEDS7978AKMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anchorage Fracture and Orthopaedic Clinic, PC CurrentSince Oct 1, 2018 Accepting new patients
Medical Network of Alaska, LLC Current Accepting new patients
Medical Network of Alaska, LLC Current Accepting new patients
Medical Network of Alaska, LLC CurrentSince Mar 1, 2023 Accepting new patients
Anchorage Fracture and Orthopaedic Clinic, PC CurrentSince Oct 1, 2018 Accepting new patients
Medical Network of Alaska, LLC CurrentSince Mar 1, 2023 Accepting new patients
Orthoalaska LLC PastSince Jan 21, 2024 Accepting new patients
Medical Network of Alaska, LLC Past Accepting new patients
Cable & McCormick Apc PastSince Mar 15, 2014 Accepting new patients

Locations

12350 Industry Way
Ste 110
Anchorage, AK 99515
Phone (907) 206-9114

3831 Piper St
Ste 220
Anchorage, AK 99508

3831 Piper St
Ste S220
Anchorage, AK 99508
Phone (907) 212-3420

4100 Lake Otis Pkwy
Ste 108
Anchorage, AK 99508
Phone (907) 339-2455

4100 Lake Otis Pkwy
Ste 220
Anchorage, AK 99508
Phone (907) 261-7111

3122 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 864-4625

3331 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 357-2332

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jared.kirkham.1@27294.direct.athenahealth.com
  • Direct secure messaging: jared.kirkham.1@33745.direct.athenahealth.com

Organizations & group practices 9

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1144544107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY STE 108",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085230",
            "telephone_number": "907-563-3145",
            "fax_number": "833-464-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY STE 108",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085230",
            "telephone_number": "907-563-3145",
            "fax_number": "833-464-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKHAM",
        "first_name": "JARED",
        "middle_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-19",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "AK",
            "license": "MEDS7978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1610529",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.