Julia Sicilia, M.D.
Individual provider Active NPI Family Medicine Physician · Kotzebue, AK
NPI 1205935210 · NPPES record last updated Jul 22, 2011
Key facts
- NPI
- 1205935210
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 5532 (AK)
- Practice address
- 436 5TH &Ted Stevens Way
Kotzebue, AK 99752-4372 - Phone
- (907) 442-7202
- Fax
- (907) 442-7312
- NPI assigned
- Sep 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100714000780 | TX | Practitioner - Family Practice | 0244287308 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5532 | AK | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maniilaq Association | Current |
Accepting new patients | |
| Maniilaq Association | Current | Accepting new patients | |
| Maniilaq Association | Current |
Accepting new patients | |
| Mid-Hudson Family Health Institute | Family Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5532 | AK | Yes |
Addresses
Primary practice location
436 5TH &Ted Stevens Way
Kotzebue, AK 99752-4372
Mailing address
436 Ted Stevens Way
Kotzebue, AK 99752-6276
Phone (907) 442-7202
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HS191P | Medicaid | AK | |
| P00291754 | Other | AK | RAILROAD MEDICARE PIN # |
| HS190P | Medicaid | AK | |
| MD66291 | Medicaid | AK |
Other providers in Kotzebue, AK
- David C Shelton Sr.
- Maher Shenouda
- Verna Mariam Sherman
- Lisa C Shindler
- Yvette Elizabeth Shoulders
- Hilda Skin
- Harriette Slwooko
- David Cruse Smith
- Julia V Smith
- Kaelin Smith
All providers in Kotzebue, AK · Family Medicine Physician in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.