Individual provider Active NPI

Darryl G Elrod Jr., MD

  • Family Medicine Physician
  • Wasilla, AK
National Provider Identifier
1194712810
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MEDS6184 Issued in AK
Practice address
1301 W Parks Hwy Ste 101
Wasilla, AK 99654-6939
Phone
(907) 357-7781
Fax
(907) 745-6573
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 6184 AK
Family Medicine Physician 207Q00000X MEDS6184 AK Primary

Addresses

Primary practice location

1301 W Parks Hwy Ste 101
Wasilla, AK 99654-6939

Mailing address

1301 W Parks Hwy Ste 101
Wasilla, AK 99654-6939
Phone (907) 357-7781

Other identifiers 1

IdentifierTypeStateIssuer
1016699MedicaidAK

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081231000433 AK Practitioner - Obstetrics/Gynecology 7214099100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Indiana University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1301 W Parks Hwy
Suite 101
Wasilla, AK 99654-6939
Phone (907) 357-7781

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6184AKMDObstetrics & Gynecology Physician

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 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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1194712810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 W PARKS HWY STE 101",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546939",
            "telephone_number": "907-357-7781",
            "fax_number": "907-357-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W PARKS HWY STE 101",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546939",
            "telephone_number": "907-357-7781",
            "fax_number": "907-745-6573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELROD",
        "first_name": "DARRYL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AK",
            "license": "6184",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "MEDS6184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016699",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.