NPIMap

Organization Active NPI

Ophthalmic Associates a Professional Corporation

  • Ophthalmology Physician
  • Anchorage, AK
National Provider Identifier
1255325692
Registry record updated Apr 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
OPHTHALMIC ASSOCIATES A PROFESSIONAL CORPORATION
Practice address
542 W 2ND Ave
Anchorage, AK 99501-2208
Phone
(907) 276-1617
Fax
(907) 264-2664
NPI assigned
Aug 31, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2014

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

Authorized official

Name
Carl E Rosen, MDNPI 1306839873
Title
Owner / President
Phone
(907) 276-1617

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

542 W 2ND Ave
Anchorage, AK 99501-2208

Mailing address

542 W 2ND Ave
Anchorage, AK 99501-2208
Phone (907) 276-1617

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040324000384 AK Part B Supplier - Clinic/Group Practice 4183515596 Receives reassigned benefits from 11 practitioners
Practice locations: Anchorage, AK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
02D2055422Ophthalmic Associates542 West 2ND Avenue, Anchorage, AK 99501Certificate of waiverMar 11, 2027

National Provider Directory

National Provider Directory

Locations

542 W 2nd Ave
Anchorage, AK 99501
Phone (907) 276-1617

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397779200000",
    "number": "1255325692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 W 2ND AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995012208",
            "telephone_number": "907-276-1617",
            "fax_number": "907-264-2664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 W 2ND AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995012208",
            "telephone_number": "907-276-1617",
            "fax_number": "907-264-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPHTHALMIC ASSOCIATES A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-31",
        "last_updated": "2014-04-18",
        "status": "A",
        "authorized_official_last_name": "ROSEN",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER / PRESIDENT",
        "authorized_official_telephone_number": "907-276-1617",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.