Organization Active NPI

Mat-Su Midwifery Inc

  • Midwife
  • Wasilla, AK
National Provider Identifier
1275696486
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
AA10 Issued in AK
Legal business name
MAT-SU MIDWIFERY INC
Practice address
5000 E Shennum Dr
Wasilla, AK 99654-7718
Phone
(907) 373-3420
Fax
(907) 376-7847
NPI assigned
Dec 18, 2006
Last updated
May 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Authorized official

Name
Mrs. Susanna Biederman
Title
President
Phone
(907) 373-3420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X AA10 AK Primary

Addresses

Primary practice location

5000 E Shennum Dr
Wasilla, AK 99654-7718

Mailing address

2650 Broadview Ave
Wasilla, AK 99654-8302
Phone (907) 373-3420

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150126000566 AK Part B Supplier - Clinic/Group Practice 5496079394 Receives reassigned benefits from 12 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
02D0858787Mat-Su Midwifery, Inc5000 E Shennum Dr, Wasilla, AK 99654Provider-performed microscopyMar 24, 2028

National Provider Directory

National Provider Directory

Locations

2650 E Broadview Ave
Wasilla, AK 99654
Phone (907) 373-3420

5000 E Shennum Dr
Wasilla, AK 99654
Phone (907) 373-3420

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652832000000",
    "number": "1275696486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 BROADVIEW AVE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548302",
            "telephone_number": "907-373-3420",
            "fax_number": "907-376-7847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 E SHENNUM DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547718",
            "telephone_number": "907-373-3420",
            "fax_number": "907-376-7847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAT-SU MIDWIFERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A",
        "authorized_official_last_name": "BIEDERMAN",
        "authorized_official_first_name": "SUSANNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-373-3420",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "AK",
            "license": "AA10",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 18, 2022; 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.