Individual provider Active NPI

Carolyn Knackstedt, MD

  • Family Medicine Physician
  • Anchorage, AK
National Provider Identifier
1174145809
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
225315 Issued in AK
Practice address
4951 Business Park Blvd
Anchorage, AK 99503-7174
Phone
(907) 743-7200
NPI assigned
May 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 225315 AK Primary

Addresses

Primary practice location

4951 Business Park Blvd
Anchorage, AK 99503-7174

Mailing address

4951 Business Park Blvd
Anchorage, AK 99503-7174
Phone (907) 743-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, AK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230814000749 WA Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 7517380033 Reassigns benefits to 1 organization
I20241008002125 AK Practitioner - Family Practice 7517380033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4951 Business Park Blvd
Anchorage, AK 99503-7174
Phone (907) 743-7200

Hospital & facility affiliations

  • Providence at Home With Compassus HH Anchorage Home health agency, Anchorage, AK, CCN 027001
  • Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anchorage Neighborhood Health Center Inc Family Medicine CurrentSince Sep 26, 2024 Accepting new patients
Multicare Health System Current Accepting new patients
Anchorage Neighborhood Health Center, Inc. CurrentSince Sep 26, 2024 Accepting new patients
Multicare Health System CurrentSince Jul 5, 2023 Accepting new patients
Multicare Health System CurrentSince Jul 5, 2023 Accepting new patients
Providence Health & Services Washington Past Accepting new patients

Locations

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

4951 Business Park Blvd
Anchorage, AK 99503
Phone (907) 743-7200

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

521 S K St
Tacoma, WA 98405
Phone (253) 403-2900

Organizations & group practices 6

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.

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": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1174145809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 BUSINESS PARK BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037174",
            "telephone_number": "907-743-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 BUSINESS PARK BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037174",
            "telephone_number": "907-743-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNACKSTEDT",
        "first_name": "CAROLYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "225315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.