Individual provider Active NPI

Michael L Oltman, MD

  • Family Medicine Physician
  • Anchorage, AK
National Provider Identifier
1336728088
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
178207 Issued in AK
Practice address
1201 E 36TH Ave
Anchorage, AK 99508-4372
Phone
(907) 562-9229
Fax
(907) 562-1603
NPI assigned
Apr 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 178207 AK Primary

Addresses

Primary practice location

1201 E 36TH Ave
Anchorage, AK 99508-4372

Mailing address

PO Box 4105
Portland, OR 97208-4105
Phone (866) 907-1068

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241015002271 AK Practitioner - Family Practice 4880095363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

10928 Eagle River Rd
Suite 150
Eagle River, AK 99577-8078
Phone (907) 694-8085

4951 Business Park Blvd
Anchorage, AK 99503-7174
Phone (907) 743-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Anchorage Neighborhood Health Center, Inc. CurrentSince Oct 8, 2024 Accepting new patients
Anchorage Neighborhood Health Center Inc Family Medicine CurrentSince Oct 8, 2024 Accepting new patients

Locations

4951 Business Park Blvd
Anchorage, AK 99503
Phone (907) 743-7200

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1336728088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084105",
            "telephone_number": "866-907-1068",
            "fax_number": "425-917-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E 36TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084372",
            "telephone_number": "907-562-9229",
            "fax_number": "907-562-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLTMAN",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-07",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "178207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.