Individual provider Active NPI

Matthew Mark Huckabee, DO

  • Psychiatry Physician
  • Anchorage, AK
National Provider Identifier
1477934636
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
5101021912 Issued in MI
Practice address
3760 Piper St Ste 1108
Anchorage, AK 99508
Phone
(907) 212-6900
Fax
(907) 212-6936
NPI assigned
Jun 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 5101021912 MI Primary

Addresses

Primary practice location

3760 Piper St Ste 1108
Anchorage, AK 99508

Mailing address

3760 Piper St Ste 1108
Anchorage, AK 99508-4683
Phone (907) 212-6900

Other practice location 1

909 Fee Rd Rm B119
MSU and Affiliated Hospitals
East Lansing, MI 48824-6410
Phone (517) 353-3070

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mhuckabee1162000@ak.providencedirect.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191028002134 AK Practitioner - Psychiatry 6507113503 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services - WashingtonGroup PAC ID 8628965910, 47 clinicians

Practice addresses (Care Compare)

3300 Providence Dr
Suite B314
Anchorage, AK 99508-4621
Phone (907) 212-3420

3760 Piper St
Suite 1108a
Anchorage, AK 99508-4683
Phone (907) 212-6900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101021912MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Oct 1, 2019 Accepting new patients
Providence Health & Services - Washington Psychiatry CurrentSince Oct 1, 2019 Accepting new patients

Locations

3760 Piper St
Ste 1108
Anchorage, AK 99508
Phone (907) 212-6900

920 Compassion Cir
Anchorage, AK 99504
Phone (907) 212-9200

3300 Providence Dr
Ste B314
Anchorage, AK 99508
Phone (907) 212-3420

3760 Piper St
Ste 1108B
Anchorage, AK 99508
Phone (907) 212-6970

3760 Piper St
Ste 1108A
Anchorage, AK 99508
Phone (907) 212-6900

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

Organizations & group practices 2

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 1

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": "1434240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1477934636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 PIPER ST STE 1108",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084683",
            "telephone_number": "907-212-6900",
            "fax_number": "907-212-6936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 PIPER ST STE 1108",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99508",
            "telephone_number": "907-212-6900",
            "fax_number": "907-212-6936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 Fee Rd Rm B119",
            "address_2": "MSU and Affiliated Hospitals",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488246410",
            "country_code": "US",
            "telephone_number": "517-353-3070",
            "fax_number": "517-432-3603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUCKABEE",
        "first_name": "MATTHEW",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-14",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101021912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhuckabee1162000@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "3760 Piper St Ste 1108",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "99508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.