Individual provider Active NPI

Carlene Kay Boden, P.A.

  • Physician Assistant
  • Anchorage, AK
National Provider Identifier
1235128349
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103852 Issued in AK
Practice address
4330 Elmore Rd
Anchorage, AK 99508-5907
Phone
(907) 729-3300
NPI assigned
Oct 20, 2005
Last updated
Dec 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 103852 AK Primary
Behavior Analyst 103K00000X BEVB12 AK

Addresses

Primary practice location

4330 Elmore Rd
Anchorage, AK 99508-5907

Mailing address

7033 E Tudor Rd
Anchorage, AK 99507-1262
Phone (907) 729-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160125001913 TX Practitioner - Physician Assistant 4880646785 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
BEVB12AKMDBehavioral Analyst
1387OKMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Southcentral Foundation CurrentSince Nov 11, 2025 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Dec 12, 2015 Accepting new patients
Oklahoma Oncology & Hematology PC Past Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4330 Elmore Rd
Anchorage, AK 99508
Phone (907) 729-6690

4501 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1000

7033 E Tudor Rd
Anchorage, AK 99507
Phone (907) 729-0000

Organizations & group practices 4

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1235128349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7033 E TUDOR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071262",
            "telephone_number": "907-729-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 ELMORE RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085907",
            "telephone_number": "907-729-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODEN",
        "first_name": "CARLENE",
        "middle_name": "KAY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-20",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "103852",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AK",
            "license": "BEVB12",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.