Amy Renee Mozolik, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY P 660 Issued in AK

Practice address

401 E Fireweed LN Ste 201
Anchorage, AK 99503-2100

Phone

(907) 306-6760

Fax

(844) 513-4092

NPI assigned

Aug 18, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Providence Health & Services- Washington

  dba Providence Medical Group Alaska

  • Critical Care Medicine (Internal Medicine) Physician
  • Anchorage, AK
  • NPI 1093956278
  NPD (past)

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

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1366757049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 230812",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995230812",
            "telephone_number": "907-306-6760",
            "fax_number": "844-513-4092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E FIREWEED LN STE 201",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032100",
            "telephone_number": "907-306-6760",
            "fax_number": "844-513-4092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOZOLIK",
        "first_name": "AMY",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-18",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "533-226",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AK",
            "license": "PSY P 660",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AK",
            "license": "732",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1579978",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Movement Therapeutics, LLC
• Moving Mountains Occupational Therapy, LLC
• Kjeirstan Movius
• Melissa M Moxlow Swan, MS, LPC, LPC-S
• Sabeena Mozaffar
• Kate M. Mraz, MS
• Michael Kirwan Mraz, MD
• Timothy Mraz
• MSM Anchorage LLC
• MSM Inc (Whole Health Chiropractic)

• Psychologist in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Psychologist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.