Individual provider Active NPI

Constance J. Dafoe-Rueb, MS, RD, LD

  • Registered Dietitian
  • Anchorage, AK
National Provider Identifier
1558619403
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
291 Issued in AK
Practice address
4100 Lake Otis Pkwy Ste 322
Anchorage, AK 99508-5231
Phone
(907) 562-1234
Fax
(907) 677-2007
NPI assigned
Aug 27, 2012
Last updated
Apr 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 291 AK Primary

Addresses

Primary practice location

4100 Lake Otis Pkwy Ste 322
Anchorage, AK 99508-5231

Mailing address

3801 Lake Otis Pkwy Ste 300
Anchorage, AK 99508-5234
Phone (907) 562-2277

Other names 1

  • Mrs. Connie J. Dafoe-Rueb Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121119000286 AK Practitioner - Registered Dietitian Or Nutrition Professional 6103077250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
University of Nebraska College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthoalaska LLCGroup PAC ID 2961705520, 167 clinicians

Practice addresses (Care Compare)

4100 Lake Otis Pkwy
Suite 322
Anchorage, AK 99508-5231
Phone (907) 562-1234

Merit-based Incentive Payment System (MIPS)

Final score
75.68 of 100Reported as group
Quality
52.97
Promoting interoperability
88
Improvement activities
40
Cost
73.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoalaska, LLC Dietitian, Registered CurrentSince Nov 1, 2021 Accepting new patients
Orthoalaska LLC CurrentSince Nov 1, 2021 Accepting new patients
Orthoalaska, LLC Past Accepting new patients
Orthoalaska LLC PastSince Jan 21, 2024 Accepting new patients

Locations

3801 Lake Otis Pkwy
Ste 300
Anchorage, AK 99508
Phone (907) 341-5238

4100 Lake Otis Pkwy
Ste 100
Anchorage, AK 99508
Phone (907) 563-4006

4100 Lake Otis Pkwy
Ste 322
Anchorage, AK 99508
Phone (907) 562-1234

17101 Snowmobile Ln
Ste 102
Eagle River, AK 99577
Phone (907) 694-7223

3125 E Meridian Park Loop
Ste 150
Wasilla, AK 99654
Phone (907) 864-5025

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1558619403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 LAKE OTIS PKWY STE 300",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085234",
            "telephone_number": "907-562-2277",
            "fax_number": "907-563-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY STE 322",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085231",
            "telephone_number": "907-562-1234",
            "fax_number": "907-677-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAFOE-RUEB",
        "first_name": "CONSTANCE",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-27",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AK",
            "license": "291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "DAFOE-RUEB",
            "middle_name": "J.",
            "prefix": "MRS.",
            "credential": "MS, RD, LD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.