NPIMap

Individual provider Active NPI

Wandal Bryan Winn, M.D.

  • Diagnostic Radiology Physician
  • Anchorage, AK
National Provider Identifier
1154370781
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
5849 Issued in AK
Practice address
3200 Providence Dr
Anchorage, AK 99508-4661
Phone
(907) 339-9455
Fax
(907) 339-9445
NPI assigned
May 10, 2006
Last updated
Jun 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 5849 AK Primary

Addresses

Primary practice location

3200 Providence Dr
Anchorage, AK 99508-4661

Mailing address

3650 Piper St
Ste a
Anchorage, AK 99508-4692
Phone (907) 339-9455

Other identifiers 1

IdentifierTypeStateIssuer
231431MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060613000304 AK Practitioner - Diagnostic Radiology 2264409390 Reassigns benefits to 2 organizations
I20200220002149 TX Practitioner - Diagnostic Radiology 2264409390 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Washington School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imaging Associates LLCGroup PAC ID 4284641986, 23 clinicians
Alaska Radiology Associates IncGroup PAC ID 0648182725, 37 clinicians

Practice addresses (Care Compare)

12001 Business Blvd
Suite 3a
Eagle River, AK 99577-7743
Phone (907) 746-4646

2280 Woodworth Loop
Palmer, AK 99645
Phone (907) 565-8010

3650 Piper St
Suite a
Anchorage, AK 99508-4692
Phone (901) 222-4624

6065 Cobblestone Hill Rd
Anchorage, AK 99516-5072
Phone (907) 222-4624

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.5 of 100Reported as group
Quality
91.25
Improvement activities
40
Cost
44.39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Radiology Associates Inc CurrentSince Jul 1, 2006 Accepting new patients
Norton Sound Health Corporation Current Accepting new patients
Imaging Associates, LLC Diagnostic Radiology CurrentSince Jul 1, 2006 Accepting new patients
Maniilaq Association CurrentSince Nov 1, 2019 Accepting new patients
Maniilaq Association CurrentSince Nov 1, 2019 Accepting new patients
Maniilaq Association Current Accepting new patients
Diagnostic Imaging Associates Inc Diagnostic Radiology Past Accepting new patients

Locations

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

3650 Piper St
Ste A
Anchorage, AK 99508
Phone (907) 339-9455

2280 S Woodworth Loop
Palmer, AK 99645
Phone (907) 565-8010

Interoperability endpoints

  • Direct secure messaging: wwinn@direct.nshcorp.org

Organizations & group practices 7

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1154370781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 PIPER ST",
            "address_2": "STE A",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084692",
            "telephone_number": "907-339-9455",
            "fax_number": "907-339-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 PROVIDENCE DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084661",
            "telephone_number": "907-339-9455",
            "fax_number": "907-339-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINN",
        "first_name": "WANDAL",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AK",
            "license": "5849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231431",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.