Individual provider Active NPI

Brittany Shantel Burglin Stepovich, ANP

  • Nurse Practitioner
  • Fairbanks, AK
National Provider Identifier
1174830673
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1172 Issued in AK
Practice address
1650 Cowles St
Fairbanks, AK 99701-5907
Phone
(907) 458-5380
Fax
(907) 458-5379
NPI assigned
Sep 3, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1172 AK Primary

Addresses

Primary practice location

1650 Cowles St
Fairbanks, AK 99701-5907

Mailing address

1650 Cowles St
Fairbanks, AK 99701-5907
Phone (907) 458-5380

Other identifiers 1

IdentifierTypeStateIssuer
1570715MedicaidAK

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110121001030 AK Practitioner - Nurse Practitioner 5991984965 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanana Valley Clinic LLCGroup PAC ID 5698056901, 142 clinicians

Practice addresses (Care Compare)

1650 Cowles St
Fairbanks, AK 99701-5907
Phone (907) 459-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.86 of 100Reported as group
Quality
94.88
Promoting interoperability
100
Improvement activities
40
Cost
79.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1172AKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Fairbanks Cancer Care Physicians CurrentSince Oct 7, 2010 Accepting new patients
Tanana Valley Clinic LLC CurrentSince Oct 1, 2019 Accepting new patients
Tanana Valley Clinic LLC CurrentSince Oct 1, 2019 Accepting new patients

Locations

1640 Cowles St
Ste 1
Fairbanks, AK 99701
Phone (907) 452-4268

1001 Noble St
Fairbanks, AK 99701
Phone (907) 276-2806

1650 Cowles St
Fairbanks, AK 99701
Phone (907) 452-8181

Interoperability endpoints

  • Direct secure messaging: brittany.stepovich@direct.tananavalley.nextgenshare.com

Organizations & group practices 3

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 1

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": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1174830673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015907",
            "telephone_number": "907-458-5380",
            "fax_number": "907-458-5379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015907",
            "telephone_number": "907-458-5380",
            "fax_number": "907-458-5379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPOVICH",
        "first_name": "BRITTANY",
        "middle_name": "SHANTEL BURGLIN",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-03",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AK",
            "license": "1172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1570715",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.