Individual provider Active NPI

Sasha Elizabeth Ericksen, M.D.

  • Psychiatry Physician
  • Fairbanks, AK
National Provider Identifier
1275556144
Registry record updated Apr 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MEDS5486 Issued in AK
Practice address
122 1St Ave Ste 600
Fairbanks, AK 99701-4871
Phone
(907) 459-3800
Fax
(907) 459-3810
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MEDS5486 AK Primary

Addresses

Primary practice location

122 1St Ave Ste 600
Fairbanks, AK 99701-4871

Mailing address

PO Box 94429
Seattle, WA 98124-6729
Phone (907) 451-6682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190403000901 WA Practitioner - Psychiatry 0446255269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

325 E Pioneer
Puyallup, WA 98372-3265
Phone (253) 445-8120

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Jan 26, 2019 Accepting new patients
Multicare Health System CurrentSince Jan 26, 2019 Accepting new patients
Multicare Health System Current Accepting new patients
Fairbanks Psychiatric and Neurological Clinic a Prof Corp Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

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.

Hospital & facility affiliations 1

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491609600000",
    "number": "1275556144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94429",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981246729",
            "telephone_number": "907-451-6682",
            "fax_number": "907-459-3811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 1ST AVE STE 600",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014871",
            "telephone_number": "907-459-3800",
            "fax_number": "907-459-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSEN",
        "first_name": "SASHA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2017-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AK",
            "license": "MEDS5486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.