Individual provider Active NPI

Deana K Glick, PA-C

  • Medical Physician Assistant
  • Anchorage, AK
National Provider Identifier
1457722118
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
103337 Issued in AK
Practice address
4951 Business Park Blvd
Anchorage, AK 99503
Phone
(907) 743-7200
NPI assigned
Oct 7, 2015
Last updated
May 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 103337 AK Primary

Addresses

Primary practice location

4951 Business Park Blvd
Anchorage, AK 99503

Mailing address

4951 Business Park Blvd
Anchorage, AK 99503-7174
Phone (907) 743-7200

Other practice location 1

3801 Lake Otis Pkwy
Suite 300
Anchorage, AK 99508-5234
Phone (907) 562-2277

Other practice location 2

3801 Lake Otis Pkwy
Suite 300
Anchorage, AK 99508-5234
Phone (907) 562-2277

Other identifiers 1

IdentifierTypeStateIssuer
1636243MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151230001453 AK Practitioner - Physician Assistant 5092017541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

10928 Eagle River Rd
Suite 150
Eagle River, AK 99577-8078
Phone (907) 694-8085

4951 Business Park Blvd
Anchorage, AK 99503-7174
Phone (907) 743-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anchorage Neighborhood Health Center, Inc. CurrentSince Jul 31, 2017 Accepting new patients
Orthoalaska LLC PastSince Jan 21, 2024 Accepting new patients

Locations

4951 Business Park Blvd
Anchorage, AK 99503
Phone (907) 743-7200

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1457722118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 BUSINESS PARK BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037174",
            "telephone_number": "907-743-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 BUSINESS PARK BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99503",
            "telephone_number": "907-743-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Lake Otis Pkwy",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995085234",
            "country_code": "US",
            "telephone_number": "907-562-2277",
            "fax_number": "907-563-3460",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3801 Lake Otis Pkwy",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995085234",
            "country_code": "US",
            "telephone_number": "907-562-2277",
            "fax_number": "907-563-3460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLICK",
        "first_name": "DEANA",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-07",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "103337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1636243",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.