NPIMap

Organization Active NPI

Bartlett Regional Hospital

Doing business as Bartlett Surgery & Specialty Clinic

  • Surgery Physician
  • Juneau, AK
National Provider Identifier
1508044835
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
BARTLETT REGIONAL HOSPITAL
Doing business as
Bartlett Surgery & Specialty Clinic
Practice address
3268 Hospital Dr Ste a
Juneau, AK 99801-7800
Phone
(907) 796-8700
Fax
(907) 796-8710
NPI assigned
Feb 8, 2008
Last updated
Nov 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Authorized official

Name
Joseph Wanner
Title
Chief Executive Officer
Phone
(907) 796-8687

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

3268 Hospital Dr Ste a
Juneau, AK 99801-7800

Mailing address

3260 Hospital Dr
Juneau, AK 99801-7808
Phone (907) 796-8700

Other names 1

  • Bartlett Surgery & Specialty Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080424000506 AK Part B Supplier - Clinic/Group Practice 1759469174 Receives reassigned benefits from 29 practitioners
Practice locations: Juneau, AK

National Provider Directory

National Provider Directory

Locations

3225 Hospital Dr
Unit 101A
Juneau, AK 99801
Phone (907) 523-5411

Practitioners & affiliated clinicians

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1508044835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 HOSPITAL DR",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017808",
            "telephone_number": "907-796-8700",
            "fax_number": "907-796-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3268 HOSPITAL DR STE A",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017800",
            "telephone_number": "907-796-8700",
            "fax_number": "907-796-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARTLETT REGIONAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-08",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "WANNER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "907-796-8687"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bartlett Surgery & Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bartlett Surgery & Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Juneau, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.