NPIMap

Organization Active NPI

Matt a. Heilala, DPM Inc.

Doing business as Alaska Foot & Ankle Specialists

  • Foot & Ankle Surgery Podiatrist
  • Anchorage, AK
National Provider Identifier
1316046790
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
4087 Issued in AK
Legal business name
MATT A. HEILALA, DPM INC.
Doing business as
Alaska Foot & Ankle Specialists
Practice address
4100 Lake Otis Pkwy
Suite 312
Anchorage, AK 99508-5222
Phone
(907) 569-3668
Fax
(907) 569-3669
NPI assigned
Sep 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Matt A. Heilala, D.P.M.NPI 1821135427
Title
President
Phone
(907) 569-3668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 3497 AK
Foot & Ankle Surgery Podiatrist 213ES0103X 4087 AK Primary

Addresses

Primary practice location

4100 Lake Otis Pkwy
Suite 312
Anchorage, AK 99508-5222

Mailing address

4100 Lake Otis Pkwy
Suite 312
Anchorage, AK 99508-5222
Phone (907) 569-3668

Other identifiers 2

IdentifierTypeStateIssuer
PD5195MedicaidAK
PD3497MedicaidAK

Other names 1

  • Alaska Foot & Ankle Specialists Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000251 AK Part B Supplier - Clinic/Group Practice 3779496294 Receives reassigned benefits from 13 practitioners
Practice locations: Anchorage, AK; Wasilla, AK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316046790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY",
            "address_2": "SUITE 312",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085222",
            "telephone_number": "907-569-3668",
            "fax_number": "907-569-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY",
            "address_2": "SUITE 312",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085222",
            "telephone_number": "907-569-3668",
            "fax_number": "907-569-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATT A. HEILALA, DPM INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEILALA",
        "authorized_official_first_name": "MATT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-569-3668",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AK",
            "license": "3497",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AK",
            "license": "4087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PD5195",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PD3497",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alaska Foot & Ankle Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.