Pamela M Haughom, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

120423 Issued in AK

Practice address

3841 Piper St Ste T4-020
Anchorage, AK 99508-4673

Phone

(907) 646-8500

NPI assigned

Jul 13, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Pamela M Kove Other name

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain West Derm - Blackhart PLLCGroup PAC ID 1153609813, 103 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Mountain West Derm - Blackhart PLLC

  dba Alaska Center for Dermatology

  • Dermatology Physician
  • Anchorage, AK
  • NPI 1124670088
  Medicare reassignment Care Compare group NPD
• Mountain West Derm-Blackhart, PLLC

  • Dermatology Physician
  • Tigard, OR
  • NPI 1316656994
  NPD
• Dermatology Associates,P.C.

  • Specialist
  • Tigard, OR
  • NPI 1851442461
  NPD (past)
• Midwest Orthopaedics at Rush, LLC

  • Orthopaedic Surgery Physician
  • Chicago, IL
  • NPI 1811942451
  NPD (past)

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

• Providence Health & Services Washington

  dba Providence Alaska Medical Center

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119
  Care Compare affiliation

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1477818680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 PIPER ST STE T4-020",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084673",
            "telephone_number": "907-646-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3841 PIPER ST STE T4-020",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084673",
            "telephone_number": "907-646-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGHOM",
        "first_name": "PAMELA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-13",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085-004350",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "120423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "KOVE",
            "middle_name": "M",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Julie Hathaway, RN, BSN
• Megan Renee Hathcoat, NP
• Gregory Hau, PA
• Timothy Haugan
• Bryan Daniel Haughom, MD
• Alicia Haugstad, FDNP, HEALTH COACH
• Christopher Joseph Haupt-Chronister, FNP-C
• Rebekah Lindeen Haussner, LPC, CDCI
• Erik K. Hauswald, MD
• Haven

• Physician Assistant in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.