NPIMap

Individual provider Active NPI

Wade Erickson, MD

  • Family Medicine Physician
  • Wasilla, AK
National Provider Identifier
1245278183
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4593 Issued in AK
Practice address
3066 E Meridian Park Loop
Wasilla, AK 99654-7299
Phone
(907) 357-9593
NPI assigned
Jun 3, 2006
Last updated
Oct 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 4593 AK
Family Medicine Physician 207Q00000X 4593 AK Primary

Addresses

Primary practice location

3066 E Meridian Park Loop
Wasilla, AK 99654-7299

Mailing address

3066 E Meridian Park Loop
Wasilla, AK 99654-7299
Phone (907) 357-9593

Other identifiers 1

IdentifierTypeStateIssuer
MD45932MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040310000457 AK Practitioner - Family Practice 1658269626 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Medical Network of Alaska LLCGroup PAC ID 3072618859, 70 clinicians

Practice addresses (Care Compare)

10928 Eagle River Rd
Suite 150
Eagle River, AK 99577-8078
Phone (907) 694-8085

3122 E Meridian Park Loop
Wasilla, AK 99654-7255
Phone (907) 357-9590

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.46 of 100Reported as individual
Quality
85.42
Promoting interoperability
99
Improvement activities
40
Cost
80.28

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy34
Melanoma (skin cancer) excision1-10
Removal of skin lesions19
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4593AKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
New Frontier Anesthesia, LLC CurrentSince Dec 1, 2016 Accepting new patients
Mat-Su Valley Medical Center LLC CurrentSince Sep 1, 2008 Accepting new patients
Medical Network of Alaska, LLC Current Accepting new patients
Mat Su Valley Medical Center LLC CurrentSince Sep 1, 2008 Accepting new patients
Medical Network of Alaska, LLC CurrentSince Dec 2, 2006 Accepting new patients
Family Health Center, PC PastSince Mar 1, 2003 Accepting new patients
Medical Network of Alaska, LLC Past Accepting new patients
Alaska Physician Services,LLC Past Accepting new patients
Exexias Metrita - Anchorage LLC PastSince Mar 1, 2015 Accepting new patients

Locations

4001 Laurel St
Ste A
Anchorage, AK 99508
Phone (907) 563-1800

515 E Dahlia Ave
Palmer, AK 99645
Phone (907) 352-2882

3066 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 357-2332

3066 E Meridian Park Loop
Ste 3
Wasilla, AK 99654

3122 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 864-4625

3223 E Palmer Wasilla Hwy
Ste 2
Wasilla, AK 99654
Phone (907) 357-9593

3331 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 357-2332

950 E Bogard Rd
Wasilla, AK 99654
Phone (907) 352-2880

Interoperability endpoints

  • Direct secure messaging: wade.erickson.1@27294.direct.athenahealth.com

Organizations & group practices 10

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1245278183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E MERIDIAN PARK LOOP",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547299",
            "telephone_number": "907-357-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3066 E MERIDIAN PARK LOOP",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547299",
            "telephone_number": "907-357-9593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "WADE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AK",
            "license": "4593",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "4593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD45932",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.