Individual provider Active NPI

Leanne Kim

  • Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1376372185
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
226106 Issued in AK
Practice address
2741 Debarr Rd Ste 215
Anchorage, AK 99508-2978
Phone
(907) 563-2002
NPI assigned
Jul 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 129217 AK
Nurse Practitioner 363L00000X 226106 AK Primary

Addresses

Primary practice location

2741 Debarr Rd Ste 215
Anchorage, AK 99508-2978

Mailing address

2741 Debarr Rd Ste 215
Anchorage, AK 99508-2978
Phone (907) 563-2002

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
I20250116002277 AK Practitioner - Nurse Practitioner 0244762722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plastic Surgeons of Alaska LLCGroup PAC ID 8921157793, 5 clinicians

Practice addresses (Care Compare)

2741 Debarr Rd
Suite C215
Anchorage, AK 99508-2978
Phone (907) 563-2002

Hospital & facility affiliations

  • Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
129217AKMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Plastic Surgeons of Alaska, LLC CurrentSince Nov 29, 2024 Accepting new patients
Michael Manuel,MD,PC PastSince Nov 29, 2024 Accepting new patients

Locations

2741 Debarr Rd
Ste C215
Anchorage, AK 99508
Phone (907) 563-2002

Organizations & group practices 2

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1376372185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2741 DEBARR RD STE 215",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082978",
            "telephone_number": "907-563-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2741 DEBARR RD STE 215",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082978",
            "telephone_number": "907-563-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "LEANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "129217",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AK",
            "license": "226106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.