Angela Dawn Menish, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

194173 Issued in AK

Practice address

103 Fram Street
Petersburg, AK 99833

Phone

(907) 772-4299

Fax

(907) 772-9273

NPI assigned

Jul 11, 2022

Sex

Female

Sole proprietor

No

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 AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

The Petersburg Medical CenterGroup PAC ID 5395730626, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Petersburg Medical Center Home Home health agency, Petersburg, AK, CCN 027009
• Petersburg Medical Center Hospital, Petersburg, AK, CCN 021304
• Bartlett Regional Hospital Hospital, Juneau, AK, CCN 020008

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• The Petersburg Medical Center

  • Critical Access Hospital
  • Petersburg, AK
  • NPI 1437122843
  Medicare reassignment Care Compare group NPD
• The Petersburg Medical Center

  • Critical Access Hospital
  • Petersburg, AK
  • NPI 1790845204
  NPD

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

• Bartlett Regional Hospital

  • General Acute Care Hospital
  • Juneau, AK
  • NPI 1891849261
  Care Compare affiliation
• The Petersburg Medical Center

  • Critical Access Hospital
  • Petersburg, AK
  • NPI 1437122843
  Care Compare affiliation
• The Petersburg Medical Center

  • Home Health Agency
  • Petersburg, AK
  • NPI 1790844033
  Care Compare affiliation

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1144954751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 589",
            "city": "PETERSBURG",
            "state": "AK",
            "postal_code": "998330589",
            "telephone_number": "907-772-4299",
            "fax_number": "907-772-9273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 FRAM STREET",
            "city": "PETERSBURG",
            "state": "AK",
            "postal_code": "99833",
            "telephone_number": "907-772-4299",
            "fax_number": "907-772-9273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENISH",
        "first_name": "ANGELA",
        "middle_name": "DAWN",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "194173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla Lombardo
• Mindy Lopez
• Brenda Louise
• Natocha E. Lyons X
• Stacie McKinley
• Erin Michael
• Audrey Miller, RD
• Mitkof Behavioral Health LLC (Mitkof Behavioral Health)
• Courtney Morrison
• Cari Mottley

• Family Nurse Practitioner in Petersburg, AK
• Providers in Petersburg, AK by specialty
• Family Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; 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.