Michael K Visick, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4739087-1205 Issued in UT

Practice address

506 Lake St
Kenai, AK 99611-6937

Phone

(907) 714-4111

Fax

(844) 412-3952

NPI assigned

Aug 8, 2006

Last updated

Dec 13, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in UT, AK2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mvisick3099550@ak.providencedirect.org

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.

• Central Peninsula General Hospital Inc.

  dba Central Peninsula Hospital

  • Rural Acute Care Hospital
  • Soldotna, AK
  • NPI 1528062429
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Central Peninsula General Hospital, Inc

  dba Central Peninsula Gastroenterology

  • Gastroenterology Physician
  • Soldotna, AK
  • NPI 1154194819
  NPD
• Central Peninsula General Hospital, Inc

  dba Central Peninsula Urology

  • Urology Physician
  • Soldotna, AK
  • NPI 1275948424
  NPD
• Ihc Health Services Inc

  dba Intermountain Springville Clinic

  • Family Medicine Physician
  • Springville, UT
  • NPI 1629104542
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• North Star Medical Imaging PLLC

  • Diagnostic Radiology Physician
  • Mount Vernon, WA
  • NPI 1144489824
  NPD
• Central Peninsula General Hospital Inc

  dba Central Peninsula Family Practice

  • Rural Acute Care Hospital
  • Kenai, AK
  • NPI 1770723967
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1225048648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "435-716-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 LAKE ST",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996116937",
            "telephone_number": "907-714-4111",
            "fax_number": "844-412-3952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 N 500 E",
            "address_purpose": "LOCATION",
            "city": "Logan",
            "state": "UT",
            "postal_code": "843412400",
            "country_code": "US",
            "telephone_number": "435-716-1940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VISICK",
        "first_name": "MICHAEL",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "4739087-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mvisick3099550@ak.providencedirect.org",
            "affiliation": "N",
            "endpointDescription": "Provider direct messaging addresss",
            "address_1": "506 Lake St",
            "city": "Kenai",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996116937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mvisick3099550@ak.providencedirect.org",
            "affiliation": "N",
            "endpointDescription": "Provider direct messaging addresss",
            "address_1": "506 Lake St",
            "city": "Kenai",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996116937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heather Vaughn
• Veritas Consulting and Counseling Services
• Gabriel L Vest
• Natalie Villegas
• Rodolfo Luis Villegas Jr.
• Amanda Waggoner
• Ronald Wagoner, PHARMD
• Christy Lynn Walker
• Jared Lee Wallace, PA-C
• Walmart Inc. (Walmart Pharmacy 10-4474)

• Pediatrics Physician in Kenai, AK
• Providers in Kenai, AK by specialty
• Pediatrics Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.