Active NPI
Scott C Deberard, DO
- Family Medicine Physician
- Anchorage, AK
National Provider Identifier
1194729731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- AK 4406
- Practice address
- 9220 Lake Otis Pkwy
Ste 9
Anchorage, AK 99507-4249 - Phone
- (907) 344-0200
- Fax
- (907) 344-0214
- NPI assigned
- Jun 10, 2005
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | AK 4406 | AK | Primary |
Addresses
Primary practice location
9220 Lake Otis Pkwy
Ste 9
Anchorage, AK 99507-4249
Mailing address
9220 Lake Otis Pkwy
Ste 9
Anchorage, AK 99507-4249
Phone (907) 344-0200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AK4406 | Other | AK | LICENSE |
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)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AK 4406 | AK | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hillside Family Medicine, LLC | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- scott.deberard@767861385920516.direct.elationemr.com
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.
-
- Family Medicine Physician
- Anchorage, AK
- NPI 1417120965
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1194729731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9220 LAKE OTIS PKWY",
"address_2": "STE 9",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995074249",
"telephone_number": "907-344-0200",
"fax_number": "907-344-0214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9220 LAKE OTIS PKWY",
"address_2": "STE 9",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995074249",
"telephone_number": "907-344-0200",
"fax_number": "907-344-0214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBERARD",
"first_name": "SCOTT",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-10",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AK",
"license": "AK 4406",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "AK4406",
"state": "AK"
}
],
"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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.