Active NPI
Axel Edward Anaruk II
- Counselor
- Bethel, AK
National Provider Identifier
1417568726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 5016 Noel Polty Blvd.
Bethel, AK 99559-1029 - Phone
- (907) 543-6800
- Fax
- (907) 543-7101
- NPI assigned
- Aug 11, 2020
- Last updated
- Aug 11, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
5016 Noel Polty Blvd.
Bethel, AK 99559-1029
Mailing address
P.O. Box 1029
Attn: BH McCann Treatment Center
Bethel, AK 99559
Phone (907) 543-6800
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1020986 | Medicaid | AK | |
| 1006017 | Medicaid | AK | |
| 158987 | Medicaid | AK |
Other names 1
- Leif Ketil Sara
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yukon-Kuskokwim Health Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatric Residential Treatment Facility
- Bethel, AK
- NPI 1467679936
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597104000000",
"number": "1417568726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 1029",
"address_2": "ATTN: BH MCCANN TREATMENT CENTER",
"city": "BETHEL",
"state": "AK",
"postal_code": "99559",
"telephone_number": "907-543-6800",
"fax_number": "907-543-7101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5016 NOEL POLTY BLVD.",
"city": "BETHEL",
"state": "AK",
"postal_code": "995591029",
"telephone_number": "907-543-6800",
"fax_number": "907-543-7101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANARUK",
"first_name": "AXEL",
"middle_name": "EDWARD",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-11",
"last_updated": "2020-08-11",
"certification_date": "2020-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1020986",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1006017",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "158987",
"state": "AK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LEIF",
"last_name": "SARA",
"middle_name": "KETIL",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bethel, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.