North Star Plastic Surgery LLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

NORTH STAR PLASTIC SURGERY LLC

Practice address

562 University Ave Ste 101
Fairbanks, AK 99709-3603

Phone

(907) 415-1884

Fax

(855) 678-0909

NPI assigned

Jan 31, 2023

Organization subpart

No

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

Authorized official

Name

Erick G Martell, MDNPI 1649303694

Title

Owner

Phone

(907) 415-1884

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Locations

Practitioners 2

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

• Erick G Martell, MD

  • Plastic Surgery Physician
  • Fairbanks, AK
  • NPI 1649303694
  Medicare reassignment NPD Authorized official
• Jennifer A Lucey, PA-C

  • Surgical Physician Assistant
  • Fairbanks, AK
  • NPI 1811248073
  Medicare reassignment

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787702400000",
    "number": "1417653569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "562 UNIVERSITY AVE STE 101",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093603",
            "telephone_number": "907-415-1884",
            "fax_number": "855-678-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 UNIVERSITY AVE STE 101",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093603",
            "telephone_number": "907-415-1884",
            "fax_number": "855-678-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH STAR PLASTIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-31",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A",
        "authorized_official_last_name": "MARTELL",
        "authorized_official_first_name": "ERICK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-415-1884",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720992",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Plastic and Reconstructive Surgery Physician in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Plastic and Reconstructive Surgery Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.