Individual provider Active NPI

Lydia L May, ANP

  • Women's Health Nurse Practitioner
  • Wasilla, AK
National Provider Identifier
1356710859
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
102672 Issued in AK
Practice address
1301 W Parks Hwy Ste 101
Wasilla, AK 99654-6939
Phone
(907) 357-7781
NPI assigned
Sep 15, 2015
Last updated
Aug 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 102672 AK Primary

Addresses

Primary practice location

1301 W Parks Hwy Ste 101
Wasilla, AK 99654-6939

Mailing address

1301 W Parks Hwy Ste 101
Wasilla, AK 99654-6939
Phone (907) 357-7781

Other identifiers 2

IdentifierTypeStateIssuer
102672OtherAKALASKA BOARD OF NURSING LICENSE
1631831MedicaidAK

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
I20220802002596 AK Practitioner - Nurse Practitioner 3072820489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Network of Alaska LLCGroup PAC ID 3072618859, 70 clinicians

Practice addresses (Care Compare)

3122 E Meridian Park Loop
Wasilla, AK 99654-7255
Phone (907) 357-9590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Network of Alaska, LLC Current Accepting new patients
Medical Network of Alaska, LLC Current Accepting new patients
Medical Network of Alaska, LLC CurrentSince Oct 1, 2022 Accepting new patients
Medical Network of Alaska, LLC CurrentSince Oct 1, 2022 Accepting new patients

Locations

3122 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 864-4625

3331 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 357-2332

3765 E Blue Lupine Dr
Ste C
Wasilla, AK 99654
Phone (907) 357-9560

Interoperability endpoints

  • Direct secure messaging: lydia.petersen.2@27294.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1356710859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 W PARKS HWY STE 101",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546939",
            "telephone_number": "907-357-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W PARKS HWY STE 101",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546939",
            "telephone_number": "907-357-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAY",
        "first_name": "LYDIA",
        "middle_name": "L",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-15",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AK",
            "license": "102672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALASKA BOARD OF NURSING LICENSE",
            "identifier": "102672",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1631831",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.