Individual provider Active NPI

Jane Sonnenburg, PA-C

  • Medical Physician Assistant
  • Anchorage, AK
National Provider Identifier
1518968403
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
759 Issued in AK
Practice address
2741 Debarr Rd
Ste. C-308
Anchorage, AK 99508-2961
Phone
(907) 272-3366
Fax
(907) 272-0269
NPI assigned
Aug 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 759 AK Primary
Medical Physician Assistant 363AM0700X PA61298356 WA

Addresses

Primary practice location

2741 Debarr Rd
Ste. C-308
Anchorage, AK 99508-2961

Mailing address

PO Box 808
Veradale, WA 99037-0808
Phone (509) 363-3100

Other identifiers 1

IdentifierTypeStateIssuer
PA61298356OtherWASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230721002515 OR Practitioner - Physician Assistant 8224063318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pain Care of Oregon LLCGroup PAC ID 3779550785, 12 clinicians

Practice addresses (Care Compare)

825 Bennett Ave
Medford, OR 97504-6715
Phone (541) 779-5228

842 E Main St
Medford, OR 97504-7134
Phone (541) 779-5228

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
759AKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoalaska, LLC Past Accepting new patients
Medical Group of Alaska Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DACAAA

Organizations & group practices 3

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 5

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1518968403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 808",
            "city": "VERADALE",
            "state": "WA",
            "postal_code": "990370808",
            "telephone_number": "509-363-3100",
            "fax_number": "509-363-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2741 DEBARR RD",
            "address_2": "STE. C-308",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082961",
            "telephone_number": "907-272-3366",
            "fax_number": "907-272-0269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONNENBURG",
        "first_name": "JANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "759",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA61298356",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA61298356",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.