Active NPI
Scott Edward Stewart, M.D.
- Pediatrics Physician
- Anchorage, AK
National Provider Identifier
1164719423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01072497A
- Practice address
- 3340 Providence Dr Ste 366
Anchorage, AK 99508-4627 - Phone
- (907) 563-3026
- NPI assigned
- Jul 6, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01072497A | IN | Primary |
Addresses
Primary practice location
3340 Providence Dr Ste 366
Anchorage, AK 99508-4627
Mailing address
9129 Squire Cir
Eagle River, AK 99577-8678
Phone (801) 336-6769
Other practice location 1
4881 Sugar Maple Dr
Dayton, OH 45424-1828
Phone (937) 257-6991
Other practice location 2
673rd MDG
5955 Zeamer Ave
Jber, AK 99506
Phone (907) 580-2907
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01072497A | IN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mat-Su Valley Medical Center LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Mat-Su Regional Medical Center
- General Acute Care Hospital
- Palmer, AK
- NPI 1417975061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637107200000",
"number": "1164719423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9129 SQUIRE CIR",
"city": "EAGLE RIVER",
"state": "AK",
"postal_code": "995778678",
"telephone_number": "801-336-6769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3340 PROVIDENCE DR STE 366",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995084627",
"telephone_number": "907-563-3026"
}
],
"practiceLocations": [
{
"address_1": "4881 Sugar Maple Dr",
"address_purpose": "LOCATION",
"city": "Dayton",
"state": "OH",
"postal_code": "454241828",
"country_code": "US",
"telephone_number": "937-257-6991",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "673rd MDG",
"address_2": "5955 Zeamer Ave",
"address_purpose": "LOCATION",
"city": "JBER",
"state": "AK",
"postal_code": "99506",
"country_code": "US",
"telephone_number": "907-580-2907",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STEWART",
"first_name": "SCOTT",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-06",
"last_updated": "2021-11-17",
"certification_date": "2021-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01072497A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.