Individual provider Active NPI

Audie Padrones, PT, MHS

  • Physical Therapist
  • Wasilla, AK
National Provider Identifier
1205884335
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
218371 Issued in AK
Practice address
3190 E Meridian Park Loop Ste 207
Wasilla, AK 99654-7422
Phone
(907) 373-9460
NPI assigned
May 4, 2006
Last updated
Dec 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 01506 MO
Physical Therapist 225100000X 218371 AK Primary

Addresses

Primary practice location

3190 E Meridian Park Loop Ste 207
Wasilla, AK 99654-7422

Mailing address

3190 E Meridian Park Loop Ste 207
Wasilla, AK 99654-7422
Phone (907) 373-9460

Other identifiers 4

IdentifierTypeStateIssuer
483897104MedicaidMO
1873945OtherMOGROUP # FOR FIRST HEALTH
410490OtherMOGROUP # FOR HEALTHLINK
120210OtherMOGROUP # FOR BC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240509002369 AK Practitioner - Physical Therapist in Private Practice 6608035845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Group of AlaskaGroup PAC ID 7416243076, 10 clinicians

Practice addresses (Care Compare)

3190 E Meridian Park Loop
Suite 207
Wasilla, AK 99654-7422
Phone (907) 373-9460

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
55.96
Improvement activities
40
Cost
79.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
218371AKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Group of Alaska CurrentSince Apr 1, 2024 Accepting new patients
Medical Group of Alaska CurrentSince Apr 1, 2024 Accepting new patients
Medical Group of Alaska Past Accepting new patients

Locations

4361 Boniface Pkwy
Ste 3
Anchorage, AK 99504
Phone (907) 333-2133

3190 E Meridian Park Loop
Ste 206
Wasilla, AK 99654
Phone (907) 373-2544

3190 E Meridian Park Loop
Ste 207
Wasilla, AK 99654
Phone (907) 357-7710

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DACAAA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1205884335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3190 E MERIDIAN PARK LOOP STE 207",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547422",
            "telephone_number": "907-373-9460",
            "fax_number": "907-373-9461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 E MERIDIAN PARK LOOP STE 207",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547422",
            "telephone_number": "907-373-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADRONES",
        "first_name": "AUDIE",
        "name_prefix": "Mr.",
        "credential": "PT, MHS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "01506",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "218371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "483897104",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP # FOR FIRST HEALTH",
            "identifier": "1873945",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP # FOR HEALTHLINK",
            "identifier": "410490",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP # FOR BC/BS",
            "identifier": "120210",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.