Active NPI
Paul John Bautista Nicdao
- Adult Care Home Facility
- Anchorage, AK
National Provider Identifier
1548170012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- License
- 2205134
- Practice address
- 6504 Mink Ave
Anchorage, AK 99504-2531 - Phone
- (907) 947-2416
- NPI assigned
- Sep 8, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | 2205134 | AK | Primary |
Addresses
Primary practice location
6504 Mink Ave
Anchorage, AK 99504-2531
Mailing address
6504 Mink Ave
Anchorage, AK 99504-2531
Phone (907) 947-2416
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788825600000",
"number": "1548170012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6504 MINK AVE",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995042531",
"telephone_number": "907-947-2416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6504 MINK AVE",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995042531",
"telephone_number": "907-947-2416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICDAO",
"first_name": "PAUL JOHN",
"middle_name": "BAUTISTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-09-08",
"last_updated": "2026-09-08",
"certification_date": "2026-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "AK",
"license": "2205134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.