NPIMap

Organization Active NPI

Urgent Care at Lake Lucille Inc

  • Urgent Care Clinic/Center
  • Wasilla, AK
National Provider Identifier
1275587768
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
3064 Issued in AK
Legal business name
URGENT CARE AT LAKE LUCILLE INC
Practice address
185 E Parks Hwy
Wasilla, AK 99654-7038
Phone
(907) 373-4203
Fax
(907) 373-4201
NPI assigned
May 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Authorized official

Name
Mrs. Ellen R Varosi
Title
Financial Officer
Phone
(907) 373-4200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 3064 AK
Urgent Care Clinic/Center 261QU0200X 3064 AK Primary

Addresses

Primary practice location

185 E Parks Hwy
Wasilla, AK 99654-7038

Mailing address

185 E Parks Hwy
Wasilla, AK 99654-7038
Phone (907) 373-4203

Other identifiers 2

IdentifierTypeStateIssuer
MDG043MedicaidAK
MDG496MedicaidAK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405000688 AK Part B Supplier - Clinic/Group Practice 3274526546 Receives reassigned benefits from 14 practitioners
Practice locations: Wasilla, 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
02D0892730Urgent Care at Lake Lucille185 East Parks Highway, Wasilla, AK 99654Certificate of waiverMar 20, 2028

National Provider Directory

National Provider Directory

Locations

185 E Parks Hwy
Wasilla, AK 99654
Phone (907) 373-4200

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1275587768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 E PARKS HWY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547038",
            "telephone_number": "907-373-4203",
            "fax_number": "907-373-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 E PARKS HWY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547038",
            "telephone_number": "907-373-4203",
            "fax_number": "907-373-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URGENT CARE AT LAKE LUCILLE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "VAROSI",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "FINANCIAL OFFICER",
        "authorized_official_telephone_number": "907-373-4200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "3064",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "AK",
            "license": "3064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDG043",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDG496",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.