Organization Active NPI

Sitenga Eye Associates LLC

  • Ophthalmology Physician
  • Kenai, AK
National Provider Identifier
1346830403
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
SITENGA EYE ASSOCIATES LLC
Practice address
115 Bidarka St
Kenai, AK 99611-7741
Phone
(907) 335-3358
Fax
(907) 335-4358
NPI assigned
Jan 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Authorized official

Name
Garret Lamendola Sitenga, MDNPI 1891701736
Title
Sole Owner
Phone
(907) 335-3358

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

115 Bidarka St
Kenai, AK 99611-7741

Mailing address

115 Bidarka St
Kenai, AK 99611-7741
Phone (907) 335-3358

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210604001542 AK Part B Supplier - Clinic/Group Practice 8123427580 Receives reassigned benefits from 2 practitioners
Practice locations: Homer, AK; Kenai, AK

National Provider Directory

National Provider Directory

Locations

115 Bidarka St
Kenai, AK 99611
Phone (907) 335-3358

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1346830403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 BIDARKA ST",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117741",
            "telephone_number": "907-335-3358",
            "fax_number": "907-335-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BIDARKA ST",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117741",
            "telephone_number": "907-335-3358",
            "fax_number": "907-335-4358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SITENGA EYE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-22",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "SITENGA",
        "authorized_official_first_name": "GARRET",
        "authorized_official_middle_name": "LAMENDOLA",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "907-335-3358",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenai, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.