NPIMap

Individual provider Active NPI

Robert Loren Bridges, M.D.

  • Diagnostic Radiology Physician
  • Wasilla, AK
National Provider Identifier
1366501876
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4098 Issued in AK
Practice address
1751 E. Gardner Way
Suite B
Wasilla, AK 99654
Phone
(907) 357-1220
Fax
(907) 357-1222
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4098 AK Primary
Nuclear Radiology Physician 2085N0904X 4098 AK

Addresses

Primary practice location

1751 E. Gardner Way
Suite B
Wasilla, AK 99654

Mailing address

P.O. Box 751
Girdwood, AK 99587
Phone (907) 382-0952

Other identifiers 7

IdentifierTypeStateIssuer
MDG1553MedicaidAK
MDG1551MedicaidAK
N2018OtherAKBLUE CROSS BLUE SHIELD
MDG1552MedicaidAK
4098OtherAKSTATE OF AK MEDICAL LICEN
MD5606MedicaidAK
MDG155MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040105000178 AK Practitioner - Diagnostic Radiology 3678472172 Reassigns benefits to 1 organization
I20050610000626 TX Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 3678472172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Nuclear Medicine
Education
University of Washington School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alaska Native Tribal Health ConsortiumGroup PAC ID 6709780265, 605 clinicians

Practice addresses (Care Compare)

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

Hospital & facility affiliations

  • Alaska Native Medical Center Hospital, Anchorage, AK, CCN 020026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4098AKMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium CurrentSince Mar 24, 2025 Accepting new patients
Anchorage Fracture and Orthopaedic Clinic, PC CurrentSince Apr 25, 2011 Accepting new patients
Anchorage Fracture and Orthopaedic Clinic, PC CurrentSince Apr 25, 2011 Accepting new patients
Matrix Radiology Associates, LLC Diagnostic Radiology PastSince Feb 1, 2009 Accepting new patients
Maniilaq Association Past Accepting new patients
Cable & McCormick Apc Diagnostic Radiology Past Accepting new patients
Maniilaq Association Past Accepting new patients
Aurora Diagnostic Imaging LLC Diagnostic Radiology Past Accepting new patients

Locations

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

4100 Lake Otis Pkwy
Ste 102
Anchorage, AK 99508
Phone (907) 382-0660

3801 University Lake Dr
Ste 300
Anchorage, AK 99508
Phone (907) 563-3700

12350 Industry Way
Ste 110
Anchorage, AK 99515
Phone (907) 206-9114

4100 Lake Otis Pkwy
Ste 108
Anchorage, AK 99508
Phone (907) 339-2455

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

Organizations & group practices 8

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1366501876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 751",
            "city": "GIRDWOOD",
            "state": "AK",
            "postal_code": "99587",
            "telephone_number": "907-382-0952",
            "fax_number": "866-305-3886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 E. GARDNER WAY",
            "address_2": "SUITE B",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-357-1220",
            "fax_number": "907-357-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGES",
        "first_name": "ROBERT",
        "middle_name": "LOREN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AK",
            "license": "4098",
            "primary": true
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "AK",
            "license": "4098",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDG1553",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDG1551",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "N2018",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDG1552",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF AK MEDICAL LICEN",
            "identifier": "4098",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD5606",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDG155",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.