Organization Active NPI

John P. Muffoletto MD, PC

  • Surgery Physician
  • Anchorage, AK
National Provider Identifier
1407971369
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
3873 Issued in AK
Legal business name
JOHN P. MUFFOLETTO MD, PC
Practice address
2751 Debarr Rd
Suite 290
Anchorage, AK 99508-2953
Phone
(907) 276-1046
Fax
(907) 222-6898
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Authorized official

Name
Dr. John P. Muffoletto, MDNPI 1922123843
Title
President
Phone
(907) 276-1046

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
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 3873 AK Primary

Addresses

Primary practice location

2751 Debarr Rd
Suite 290
Anchorage, AK 99508-2953

Mailing address

2751 Debarr Rd
Suite 290
Anchorage, AK 99508-2953
Phone (907) 276-1046

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070620000000 AK Part B Supplier - Clinic/Group Practice 2163521964 Receives reassigned benefits from 1 practitioner
Practice locations: Anchorage, AK

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

2751 Debarr Rd
Ste 290
Anchorage, AK 99508
Phone (907) 276-1046

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1407971369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 DEBARR RD",
            "address_2": "SUITE 290",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082953",
            "telephone_number": "907-276-1046",
            "fax_number": "907-222-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 DEBARR RD",
            "address_2": "SUITE 290",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082953",
            "telephone_number": "907-276-1046",
            "fax_number": "907-222-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN P. MUFFOLETTO MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "MUFFOLETTO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-276-1046",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "AK",
            "license": "3873",
            "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 Oct 17, 2007; 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.