NPIMap

Individual provider Active NPI

Lauren Ashley Poulsen, PA-C

  • Physician Assistant
  • Anchorage, AK
National Provider Identifier
1558640607
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
144617 Issued in AK
Practice address
615 E 82ND Ave Ste 204
Anchorage, AK 99518-3159
Phone
(907) 865-8455
Fax
(913) 246-4901
NPI assigned
Aug 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 144617 AK Primary

Addresses

Primary practice location

615 E 82ND Ave Ste 204
Anchorage, AK 99518-3159

Mailing address

615 E 82ND Ave Ste 204
Anchorage, AK 99518-3159
Phone (907) 865-8455

Other practice location 1

615 E 82nd Ave Ste 302
Anchorage, AK 99518-3159
Phone (907) 865-8455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190718002671 TX Practitioner - Physician Assistant 5092986224 Reassigns benefits to 2 organizations
I20260313001648 AK Practitioner - Physician Assistant 5092986224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

615 E 82ND Ave
Suite 204
Anchorage, AK 99518-3159

PO Box
Suite 12976
San Antonio, TX 78212-0976

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.93 of 100Reported as group
Quality
70.1
Promoting interoperability
100
Improvement activities
40
Cost
83.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
144617AKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southcentral Foundation CurrentSince May 7, 2021 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Jun 21, 2019 Accepting new patients
Anchorage Dermatology & Cosmetics, LLC CurrentSince Mar 1, 2026 Accepting new patients
Brevard Emergency Services Past Accepting new patients
Kindae Dermatology and Aesthetics LLC PastSince Mar 1, 2026 Accepting new patients

Locations

7033 E Tudor Rd
Anchorage, AK 99507
Phone (907) 729-0000

615 E 82nd Ave
Ste 302
Anchorage, AK 99518
Phone (907) 290-4566

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

615 E 82nd Ave
Ste 204
Anchorage, AK 99518
Phone (907) 865-8455

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00011
  • Direct secure messaging: lapoulsen@direct.anthc.org

Organizations & group practices 6

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1558640607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E 82ND AVE STE 204",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995183159",
            "telephone_number": "907-865-8455",
            "fax_number": "913-246-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E 82ND AVE STE 204",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995183159",
            "telephone_number": "907-865-8455",
            "fax_number": "913-246-4901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 E 82nd Ave Ste 302",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995183159",
            "country_code": "US",
            "telephone_number": "907-865-8455",
            "fax_number": "913-246-4901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POULSEN",
        "first_name": "LAUREN",
        "middle_name": "ASHLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-08",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "144617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.