Active NPI
Bartlett Regional Hospital
- Surgery Physician
- Juneau, AK
National Provider Identifier
1508044835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- BARTLETT REGIONAL HOSPITAL
- Practice address
- 3268 Hospital Dr Ste a
Juneau, AK 99801-7800 - Phone
- (907) 796-8700
- Fax
- (907) 796-8710
- NPI assigned
- Feb 8, 2008
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080424000506 | AK | Part B Supplier - Clinic/Group Practice | 1759469174 |
Receives reassigned benefits from 29 practitioners Practice locations: Juneau, AK |
National Provider Directory
National Provider DirectoryLocations
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.
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.