Kevin Neal Jensen, D.O.

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

107880 Issued in AK

Practice address

3750 E Country Field Cir Ste B
Wasilla, AK 99654-6659

Phone

(907) 373-1410

NPI assigned

Oct 3, 2006

Last updated

Mar 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Otolaryngology

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ear Nose and Throat Specialists Alaska, IncGroup PAC ID 6204848294, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mat-Su Regional Medical Center Hospital, Palmer, AK, CCN 020006

Merit-based Incentive Payment System (MIPS)

Final score

70.59 of 100Reported as group

Quality

83.37

Promoting interoperability

100

Improvement activities

40

Cost

16.65

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Ear, Nose and Throat Specialists Alaska, Inc.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Anchorage, AK
  • NPI 1972552891
  Medicare reassignment Care Compare group NPD
• Geneva Woods Ear, Nose and Throat Associates, Inc.

  • Otolaryngology Physician
  • Anchorage, AK
  • NPI 1114936499
  NPD (past)
• Kansas Imaging Consultants, PA

  • Diagnostic Radiology Physician
  • Wichita, KS
  • NPI 1841267663
  NPD (past)

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

• Mat-Su Valley Medical Center LLC

  dba Mat-Su Regional Medical Center

  • General Acute Care Hospital
  • Palmer, AK
  • NPI 1417975061
  Care Compare affiliation

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1386739837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 E COUNTRY FIELD CIR STE B",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546659",
            "telephone_number": "907-373-1410",
            "fax_number": "907-373-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 E COUNTRY FIELD CIR STE B",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546659",
            "telephone_number": "907-373-1410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3831 Piper St Ste S433",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995086900",
            "country_code": "US",
            "telephone_number": "907-561-1421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "KEVIN",
        "middle_name": "NEAL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "AK",
            "license": "107880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1695669",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1386739837",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Todd Jennings
• Michael Wayne Jennings
• Tonia Tennille Jennings
• Jeremy Allen Jensen, MD
• Kayse Jensen
• Rebekah R Jensen
• Dawn Jerue
• Constance M. Jerz, DC
• Rebecca Lynn Jessop-Christensen, LMT, CLT
• Rebecca Faye Jett

• Otolaryngology/Facial Plastic Surgery Physician in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.