NPIMap

Organization Active NPI

Alaska Pediatric Specialties LLC

  • Specialist
  • Anchorage, AK
National Provider Identifier
1396140950
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ALASKA PEDIATRIC SPECIALTIES LLC
Practice address
3841 Piper St Ste T4-020
Anchorage, AK 99508-4673
Phone
(907) 929-7337
Fax
(907) 929-7330
NPI assigned
Oct 24, 2014
Last updated
Feb 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Authorized official

Name
Mr. Jeffrey Brent Roaten, MDNPI 1558546788
Title
President
Phone
(907) 717-9871

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

3841 Piper St Ste T4-020
Anchorage, AK 99508-4673

Mailing address

3841 Piper St Ste T4-020
Anchorage, AK 99508-4673
Phone (907) 929-7337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171024002194 AK Part B Supplier - Clinic/Group Practice 9537435284 Receives reassigned benefits from 12 practitioners
Practice locations: Anchorage, AK

National Provider Directory

National Provider Directory

Locations

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

4100 Lake Otis Pkwy
Ste 206
Anchorage, AK 99508
Phone (907) 561-5007

4100 Lake Otis Pkwy
Ste 312
Anchorage, AK 99508
Phone (907) 569-3668

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1396140950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 PIPER ST STE T4-020",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084673",
            "telephone_number": "907-929-7337",
            "fax_number": "907-929-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3841 PIPER ST STE T4-020",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084673",
            "telephone_number": "907-929-7337",
            "fax_number": "907-929-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALASKA PEDIATRIC SPECIALTIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-24",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "ROATEN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-717-9871",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.