Active NPI
Mark Ahlenius, MD
- Pediatrics Physician
- Joint Base Lewis McChord, WA
National Provider Identifier
1396278891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101266050
- Practice address
- 9040 A Jackson Ave Madigan Army Medical Center
Joint Base Lewis McChord, WA 98431-4504 - Phone
- (253) 968-1110
- NPI assigned
- Apr 11, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 838 | TX | |
| Pediatrics Physician | 208000000X | 0101266050 | VA | Primary |
Addresses
Primary practice location
9040 A Jackson Ave Madigan Army Medical Center
Joint Base Lewis McChord, WA 98431-4504
Mailing address
9040-A Jackson Ave
Madigan Hospital
Fort Lewis, WA 98431
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200730003097 | TX | Order and Referring Only - Pediatric Medicine | 2466877964 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101266050 | VA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787011200000",
"number": "1396278891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9040-A JACKSON AVE",
"address_2": "MADIGAN HOSPITAL",
"city": "FORT LEWIS",
"state": "WA",
"postal_code": "98431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040 A JACKSON AVE MADIGAN ARMY MEDICAL CENTER",
"city": "JOINT BASE LEWIS MCCHORD",
"state": "WA",
"postal_code": "984314504",
"telephone_number": "253-968-1110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHLENIUS",
"first_name": "MARK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-11",
"last_updated": "2026-08-18",
"certification_date": "2026-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "TX",
"license": "838",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101266050",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joint Base Lewis McChord, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.