Carl Lester Brown Jr., PA-C

Individual provider Active NPI Medical Physician Assistant · Anchorage, AK

NPI 1245315779 · NPPES record last updated Aug 1, 2012

Key facts

NPI
1245315779
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
0473 (AK)
Practice address
300 West Dimond Blvd.
Suite 12
Anchorage, AK 99515
Phone
(907) 341-7757
Fax
(907) 341-7760
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alaska Urgent Care LLC (13 clinicians)

Practice addresses (Care Compare)

300 E Dimond Blvd
Anchorage, AK 99515-1948
Phone (907) 341-7757

300 E Dimond Blvd
Unit 12a
Anchorage, AK 99515-1908

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20050613000310 AK Practitioner - Physician Assistant 2668416579 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
473AKMDProfessional Counselor
0473AKMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cross Road Health Ministries, Inc. Current
since Jun 1, 2011
Accepting new patients
Robert E Gieringer MD a Professional Corporation Past Accepting new patients

Locations

187 Glenn Hwy
Glennallen, AK 99588
Phone (907) 822-3203

Interoperability endpoints

  • Direct secure messaging: carl.brown.p1@direct.crossroadmc.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0473 AK Yes
Surgical Physician Assistant 363AS0400X 0473 AK

Addresses

Primary practice location

300 West Dimond Blvd.
Suite 12
Anchorage, AK 99515

Mailing address

3224 Linden Dr.
Anchorage, AK 99502
Phone (907) 243-0598

Other providers in Anchorage, AK

All providers in Anchorage, AK · Medical Physician Assistant in Alaska

Sources for this page

Verify at the official NPI Registry.