NPIMap

Individual provider Active NPI

Angus McRae Warren, MD

  • Emergency Medicine Physician
  • Soldotna, AK
National Provider Identifier
1396946794
Registry record updated Apr 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2007-00841 Issued in NC
Practice address
250 Hospital PL
Soldotna, AK 99669-7559
Phone
(907) 714-4404
NPI assigned
May 31, 2007
Last updated
Apr 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2007-00841 NC Primary

Addresses

Primary practice location

250 Hospital PL
Soldotna, AK 99669-7559

Mailing address

PO Box 117
Kasilof, AK 99610-0117
Phone (907) 398-2201

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address awarren635730@ak.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071011000656 AK Practitioner - Emergency Medicine 2163516279 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of South Carolina School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

250 Hospital PL
Soldotna, AK 99669-7559
Phone (907) 714-4515

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.44 of 100Reported as group
Quality
62.56
Promoting interoperability
81
Improvement activities
40
Cost
67.88

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2007-00841NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Star Medical Imaging PLLC Current Accepting new patients
Central Peninsula General Hospital, Inc CurrentSince Jul 24, 2007 Accepting new patients
South Peninsula Hospital, Inc CurrentSince May 2, 2018 Accepting new patients
Central Peninsula General Hospital, Inc CurrentSince Jul 24, 2007 Accepting new patients
Central Peninsula General Hospital Inc. Current Accepting new patients
South Peninsula Hospital, Inc. Emergency Medicine CurrentSince May 2, 2018 Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients

Locations

4300 Bartlett St
Homer, AK 99603
Phone (907) 235-0369

250 Hospital Pl
Soldotna, AK 99669
Phone (907) 714-4404

Interoperability endpoints

  • Direct secure messaging: angus.warren.1@14977.direct.athenahealth.com
  • Direct secure messaging: awarren635723@ak.providencedirect.org
  • Direct secure messaging: awarren635730@ak.providencedirect.org

Organizations & group practices 7

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.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713571200000",
    "number": "1396946794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 117",
            "city": "KASILOF",
            "state": "AK",
            "postal_code": "996100117",
            "telephone_number": "907-398-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 HOSPITAL PL",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697559",
            "telephone_number": "907-714-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "ANGUS",
        "middle_name": "MCRAE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2024-04-20",
        "certification_date": "2024-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2007-00841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awarren635730@ak.providencedirect.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "address_1": "250 Hospital Pl",
            "city": "Soldotna",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996697559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

Verify at the official NPI Registry.