Individual provider Active NPI

David Penn, MD

  • Hospitalist Physician
  • Anchorage, AK
National Provider Identifier
1477968485
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
123247 Issued in AK
Practice address
4300 B St Ste 200
Anchorage, AK 99503-5933
Phone
(907) 375-3355
Fax
(907) 375-3351
NPI assigned
Jun 27, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 123247 AK
Hospitalist Physician 208M00000X 123247 AK Primary

Addresses

Primary practice location

4300 B St Ste 200
Anchorage, AK 99503-5933

Mailing address

4300 B St Ste 200
Anchorage, AK 99503-5933
Phone (907) 375-3355

Other identifiers 1

IdentifierTypeStateIssuer
1613485MedicaidAK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dpenn427539@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
I20170728002203 AK Practitioner - Family PracticePractitioner - Hospitalist 9234354382 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
Warren Alpert Medical School of Brown University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alaska Hospitalist Group LLCGroup PAC ID 6507755964, 84 clinicians

Practice addresses (Care Compare)

1201 E 36TH Ave
Anchorage, AK 99508-4372
Phone (907) 562-9229

2500 S Woodworth Loop
Palmer, AK 99645-8984
Phone (907) 375-3355

910 Compassion Cir
Anchorage, AK 99504-1645
Phone (907) 212-9100

920 Compassion Cir
Anchorage, AK 99504-1645
Phone (907) 212-9200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Mar 16, 2020 Accepting new patients
City of Valdez CurrentSince Jun 25, 2022 Accepting new patients
Alaska Hospitalist Group LLC CurrentSince Jul 1, 2017 Accepting new patients
Providence Health & Services Washington Past Accepting new patients
Alaska Specialty Hospital, LLC Past Accepting new patients

Locations

1201 E 36th Ave
Anchorage, AK 99508
Phone (907) 562-9229

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

4300 B St
Ste 200
Anchorage, AK 99503
Phone (907) 276-1131

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

2500 S Woodworth Loop
Palmer, AK 99645
Phone (907) 861-6000

232 W Rockwell Ave
Soldotna, AK 99669
Phone (907) 375-3355

911 Meals Ave
Valdez, AK 99686
Phone (907) 835-2249

Interoperability endpoints

  • Direct secure messaging: dpenn427539@ak.providencedirect.org

Organizations & group practices 5

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 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": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1477968485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 B ST STE 200",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995035933",
            "telephone_number": "907-375-3355",
            "fax_number": "907-375-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 B ST STE 200",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995035933",
            "telephone_number": "907-375-3355",
            "fax_number": "907-375-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-27",
        "last_updated": "2022-07-21",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "123247",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AK",
            "license": "123247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1613485",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpenn427539@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "1201 E 36th Ave",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995084372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.