Individual provider Active NPI

Kathleen S Nuttle, PA-C

  • Medical Physician Assistant
  • Anchorage, AK
National Provider Identifier
1356349005
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PADA1037 Issued in AK
Practice address
3801 Lake Otis Pkwy
Suite 300
Anchorage, AK 99508-5234
Phone
(907) 562-2277
Fax
(907) 563-3460
NPI assigned
Jul 7, 2005
Last updated
Oct 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PADA1037 AK Primary

Addresses

Primary practice location

3801 Lake Otis Pkwy
Suite 300
Anchorage, AK 99508-5234

Mailing address

3801 Lake Otis Pkwy Ste 300
Anchorage, AK 99508-5234
Phone (907) 562-2277

Other practice location 1

13015 Old Glenn Hwy Ste 100
Eagle River, AK 99577-7572
Phone (907) 562-2277

Other practice location 2

3125 E Meridian Park Loop Ste 300
Wasilla, AK 99654-7528
Phone (907) 562-2277

Other identifiers 1

IdentifierTypeStateIssuer
1578399MedicaidAK

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120509000725 AK Practitioner - Physician Assistant 3678460615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthoalaska LLCGroup PAC ID 2961705520, 167 clinicians

Practice addresses (Care Compare)

3125 E Meridian Park Loop
Suite 300
Wasilla, AK 99654-7528
Phone (907) 357-2267

3801 Lake Otis Pkwy
Anchorage, AK 99508-5234

Merit-based Incentive Payment System (MIPS)

Final score
75.68 of 100Reported as group
Quality
52.97
Promoting interoperability
88
Improvement activities
40
Cost
73.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoalaska, LLC CurrentSince Jan 17, 2016 Accepting new patients
Orthoalaska LLC CurrentSince Jan 17, 2016 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Orthoalaska, LLC Past Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Metro Orthopedic Physical Therapy, Inc. Past Accepting new patients
Orthoalaska LLC PastSince Jan 21, 2024 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Bradford Orthopaedic & Sports Medicine Group, PC PastSince Jun 23, 2016 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PC PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Indianapolis Neurosurgical Group PastSince Jan 1, 1990 Accepting new patients
Allegheny Regional Bone and Joint Surgery PC Past Accepting new patients

Locations

3801 Lake Otis Pkwy
Ste 300
Anchorage, AK 99508
Phone (907) 341-5238

3890 University Lake Dr
Ste 110
Anchorage, AK 99508
Phone (907) 249-5542

13015 Old Glenn Hwy
Ste 100
Eagle River, AK 99577

3125 E Meridian Park Loop
Ste 150
Wasilla, AK 99654
Phone (907) 864-5025

3125 E Meridian Park Loop
Ste 300
Wasilla, AK 99654
Phone (907) 357-2267

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kathleen.nuttle.p1@direct.opaak.nextgenshare.com

Organizations & group practices 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1356349005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 LAKE OTIS PKWY STE 300",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085234",
            "telephone_number": "907-562-2277",
            "fax_number": "907-563-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 LAKE OTIS PKWY",
            "address_2": "SUITE 300",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085234",
            "telephone_number": "907-562-2277",
            "fax_number": "907-563-3460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13015 Old Glenn Hwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Eagle River",
            "state": "AK",
            "postal_code": "995777572",
            "country_code": "US",
            "telephone_number": "907-562-2277",
            "fax_number": "907-563-3460",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3125 E Meridian Park Loop Ste 300",
            "address_purpose": "LOCATION",
            "city": "Wasilla",
            "state": "AK",
            "postal_code": "996547528",
            "country_code": "US",
            "telephone_number": "907-562-2277",
            "fax_number": "907-563-3460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUTTLE",
        "first_name": "KATHLEEN",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "PADA1037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578399",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.