State of Alaska Department of Administration
Organization Active NPI Psychiatric Hospital · Anchorage, AK
NPI 1497842553 · NPPES record last updated Apr 23, 2015
Key facts
- NPI
- 1497842553
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital 283Q00000X
- Legal business name
- STATE OF ALASKA DEPARTMENT OF ADMINISTRATION
- Practice address
- 3700 Piper St
Anchorage, AK 99508-4665 - Phone
- (907) 269-7100
- Fax
- (907) 269-7251
- NPI assigned
- Oct 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Marie E. (Melissa) Ring, PH.D.
- Title
- Ceo
- Phone
- (907) 269-7100
Owners & managing parties with NPI records 1
-
Lezlee Henry-Dupoux, LCSW
Practitioners 217
-
Lelenneth Beebe, PMHNP-BC
-
Anthony Lee Blanford, M.D.
-
Shannon Rea Davis, NP-C , PMHNP
-
Sean Farley, PMHNP-BC
-
Nathan Kasukonis, D.O.
-
Joseph Vincent Pace, M.D.
-
Laura Joy Swogger, M.D.
-
James E Black, M.D.
-
Michelle Leavetha Brooks, FNP-BC
-
Yogesh Maru, M.D.
-
William Wenokor, M.D.
-
Michelle Benitez, M.D
-
Nabila S. Farooq, MD
-
Lee Ann Gee, M.D.
-
Sara Lee Geraci, ANP
-
Deborah Lynn Guris, M.D., PH.D.
-
Kahnaz Khari, MD
-
Robert John Long, M.D.
-
David R Mack, MD
Medicare Care Compare: Hospital
- Listed as
- Alaska Psychiatric Institute
- Type
- Psychiatric
- Ownership
- Government - State
- Medicare certification status
- Active
- Emergency services
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AK
Hospital certification: CCN 024002
- Legal name
- STATE OF ALASKA DEPARTMENT OF ADMINISTRATION
- Doing business as
- ALASKA PSYCHIATRIC INSTITUTE
- Certification status
- Active
- Provider type (POS)
- Hospital – Psychiatric
- Participating since
- Dec 15, 1985
- Last certification
- Jun 7, 2019
- Beds
- 95
- Ownership / control type
- State
- Organization structure
- Government · Non-profit
- Incorporated
- Jul 1, 1962 in AK
- Enrollment address
- 3700 Piper St
Anchorage, AK 99508-4665 - Hospital subgroups
- Psychiatric
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Lezlee T Henry-Dupuox |
Corporate Officer |
May 13, 2019 | |
| W-2 Managing Employee |
Sep 1, 2019 | ||
| Scott York |
Corporate Officer |
Mar 23, 2020 | |
| Gavin H Carmichael |
Corporate Officer |
Sep 17, 2018 | |
| W-2 Managing Employee |
Sep 17, 2018 | ||
| State of Alaska Department of Administration |
5% Or Greater Direct Ownership Interest | Jan 1, 1966 | 100% |
| 5% Or Greater Mortgage Interest | Jan 1, 1966 | 100% | |
| 5% Or Greater Security Interest | Jan 1, 1966 | 100% | |
| Operational/Managerial Control | Jan 1, 1966 | 100% | |
| James L Farley |
Corporate Officer |
Sep 1, 2019 | |
| Erica L Steeves |
Corporate Officer |
Sep 20, 2019 | |
| W-2 Managing Employee |
Sep 1, 2019 | ||
| Duane G Mayes |
Corporate Director |
Sep 17, 2018 | 100% |
| Tina M Williams |
Corporate Officer |
Sep 17, 2018 | |
| W-2 Managing Employee |
Sep 17, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040203000267 | AK | Part B Supplier - Clinic/Group Practice | 5395638571 |
Receives reassigned benefits from 37 practitioners Practice locations: Anchorage, AK |
| O20051107001171 | AK | Part a Provider - Hospital | 5395638571 | Practice locations: Anchorage, AK |
National Provider Directory
Locations
1025 W Barnette St
Fairbanks, AK 99701
Phone (907) 451-1653
195 E Bunnell Ave
#C
Homer, AK 99603
Phone (907) 235-8857
3412 Glacier Hwy
Juneau, AK 99801
Phone (907) 465-1255
630 Barnacle Way
#A
Kenai, AK 99611
Phone (907) 335-3400
3054 Fifth Ave
Ketchikan, AK 99901
Phone (907) 225-4350
210 Moller Ave
Sitka, AK 99835
Phone (907) 747-3255
3223 E Palmer Wasilla Hwy
Ste 3
Wasilla, AK 99654
Phone (907) 352-6600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital | 283Q00000X | Yes |
Addresses
Primary practice location
3700 Piper St
Anchorage, AK 99508-4665
Mailing address
3700 Piper St.
Anchorage, AK 99508
Phone (907) 269-7100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| K0000ZBBBB | Other | AK | PTAN - MEDICARE PART B NUMBER |
Other names
- Alaska Psychiatric Institute
Other providers in Anchorage, AK
- Hilary Starzynski
- Joan Stassel
- State of Alaska
- State of Alaska
- State of Alaska
- State of Alaska Department of Health and Social Services
- State of Alaska Dept. HLTH & Soc Serv Div. Pub HLTH Specialty Clinics
- State of Alaska Dept. of Corrections Pharmacy
- State of Alaska, Department of Administration
- James Ronald Staten
All providers in Anchorage, AK · Psychiatric Hospital in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.