NPIMap

Individual provider Active NPI

Anneliese R Petersen, MD

  • Family Medicine Physician
  • Anchorage, AK
National Provider Identifier
1457092702
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
233735 Issued in AK
Practice address
4320 Diplomacy Dr
Anchorage, AK 99508-5925
Phone
(907) 729-3300
NPI assigned
Apr 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 233735 AK Primary

Addresses

Primary practice location

4320 Diplomacy Dr
Anchorage, AK 99508-5925

Mailing address

7033 E Tudor Rd
Anchorage, AK 99507-1262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250902001282 TX Practitioner - Family Practice 4284014226 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3900 Ambassador Dr
Anchorage, AK 99508-5922
Phone (907) 563-2662

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

4320 Diplomacy Dr
Anchorage, AK 99508-5925
Phone (907) 265-4955

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
233735AKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium CurrentSince Aug 1, 2025 Accepting new patients
Southcentral Foundation Current Accepting new patients
Southcentral Foundation CurrentSince Aug 1, 2025 Accepting new patients
Southcentral Foundation CurrentSince Aug 1, 2025 Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

7033 E Tudor Rd
Anchorage, AK 99507
Phone (907) 729-0000

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

400 W Benson Blvd
Anchorage, AK 99503
Phone (907) 729-4200

Interoperability endpoints

  • Direct secure messaging: anneliese.petersen.1@18095.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1457092702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7033 E TUDOR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 DIPLOMACY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085925",
            "telephone_number": "907-729-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "ANNELIESE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-01",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "233735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.