Serine Banczak, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

58.008460 Issued in OH

Practice address

4320 Diplomacy Dr
Anchorage, AK 99508-5925

Phone

(907) 729-3300

NPI assigned

Apr 17, 2017

Last updated

Sep 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

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.

• Southcentral Foundation

  dba BSD- Detox

  • Multi-Specialty Clinic/Center
  • Anchorage, AK
  • NPI 1255881637
  NPD (past)
• Southcentral Foundation

  dba Tribal/HPG- Benteh Nuutah Primary Care Center (BNPCC)

  • Multi-Specialty Clinic/Center
  • Wasilla, AK
  • NPI 1386680056
  NPD (past)

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1306370309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18751 SARICHEF LOOP",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995778680",
            "telephone_number": "908-268-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 DIPLOMACY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085925",
            "telephone_number": "907-729-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANCZAK",
        "first_name": "SERINE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "58.008460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Balogh
• Tami J. Balts, BA
• Bernadette Baluyut
• Gloria Bamberg-Merritt, CDC I, PHD
• Edward Bancroft, O. D.
• Alexis Banda, BSW
• Arnoldtai K Bandith
• Betty Louise Bang, ANP
• Jennifer Bang
• Moriah Bang

• Family Medicine Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.