Individual provider Active NPI

Christian Paul Mortenson, MSW

  • Clinical Social Worker
  • Anchorage, AK
National Provider Identifier
1285890053
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
4045 Lake Otis Pkwy
Suite 101
Anchorage, AK 99508-5227
Phone
(907) 561-0954
Fax
(907) 561-7093
NPI assigned
Jul 31, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

4045 Lake Otis Pkwy
Suite 101
Anchorage, AK 99508-5227

Mailing address

4045 Lake Otis Pkwy
Suite 101
Anchorage, AK 99508-5227
Phone (907) 561-0954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230905003945 AK Practitioner - Clinical Social Worker 6305193731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anchorage Community Mental Health Services IncGroup PAC ID 1052213089, 40 clinicians

Practice addresses (Care Compare)

351 W Parks Hwy
Suite 200
Wasilla, AK 99654-6920
Phone (907) 563-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Anchorage Community Mental Health Services, Inc CurrentSince Jun 1, 2023 Accepting new patients
Anchorage Community Mental Health Services Inc. Current Accepting new patients
Anchorage Community Mental Health Services, Inc CurrentSince Jun 1, 2023 Accepting new patients
Southcentral Foundation Past Accepting new patients
Southcentral Foundation Past Accepting new patients

Locations

4045 Lake Otis Pkwy
Ste 209
Anchorage, AK 99508
Phone (907) 561-5440

4020 Folker St
Anchorage, AK 99508
Phone (907) 561-0954

4045 Lake Otis Pkwy
Ste 101
Anchorage, AK 99508
Phone (907) 337-5650

1423 Peger Rd
Fairbanks, AK 99709
Phone (907) 371-1300

351 W Parks Hwy
Ste 200
Wasilla, AK 99654

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.

NPI Registry JSON

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1285890053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 LAKE OTIS PKWY",
            "address_2": "SUITE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085227",
            "telephone_number": "907-561-0954",
            "fax_number": "907-561-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 LAKE OTIS PKWY",
            "address_2": "SUITE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085227",
            "telephone_number": "907-561-0954",
            "fax_number": "907-561-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSON",
        "first_name": "CHRISTIAN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-31",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.