Individual provider Active NPI

Maria Gornostaeva, MSW, LCSW

  • Clinical Social Worker
  • Wasilla, AK
National Provider Identifier
1568700870
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
118254 Issued in AK
Practice address
1363 W Spruce Ave
Wasilla, AK 99654-5327
Phone
(907) 376-2411
Fax
(907) 352-3363
NPI assigned
Jan 21, 2013
Last updated
Nov 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 118254 AK Primary
Clinical Social Worker 1041C0700X 34007274A IN
Social Worker 104100000X 33006530A IN

Addresses

Primary practice location

1363 W Spruce Ave
Wasilla, AK 99654-5327

Mailing address

1363 W Spruce Ave
Wasilla, AK 99654-5327
Phone (907) 376-2411

Other practice location 1

3261 S Big Lake Rd
Big Lake, AK 99623-9663
Phone (907) 376-2411

Other practice location 2

425 E Dahlia Ave Ste M
Palmer, AK 99645-6463
Phone (907) 376-2411

Other practice location 3

601 Wall St
Valparaiso, IN 46383-2512
Phone (219) 476-4568

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170307002087 AK Practitioner - Clinical Social Worker 9133433170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mat - Su Health Services Inc.Group PAC ID 2567354533, 30 clinicians

Practice addresses (Care Compare)

1363 W Spruce Ave
Wasilla, AK 99654-5327
Phone (907) 376-2411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33006530AINMDSocial Worker
118254AKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mat - Su Health Services Inc. CurrentSince Jan 28, 2017 Accepting new patients

Locations

425 E Dahlia Ave
Ste M
Palmer, AK 99645
Phone (907) 376-2411

1363 W Spruce Ave
Wasilla, AK 99654
Phone (907) 376-2411

Interoperability endpoints

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

Organizations & group practices 1

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": "1358726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1568700870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1363 W SPRUCE AVE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996545327",
            "telephone_number": "907-376-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1363 W SPRUCE AVE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996545327",
            "telephone_number": "907-376-2411",
            "fax_number": "907-352-3363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3261 S Big Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Big Lake",
            "state": "AK",
            "postal_code": "996239663",
            "country_code": "US",
            "telephone_number": "907-376-2411",
            "fax_number": "907-352-3363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 E Dahlia Ave Ste M",
            "address_purpose": "LOCATION",
            "city": "Palmer",
            "state": "AK",
            "postal_code": "996456463",
            "country_code": "US",
            "telephone_number": "907-376-2411",
            "fax_number": "907-352-3363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 Wall St",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463832512",
            "country_code": "US",
            "telephone_number": "219-476-4568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORNOSTAEVA",
        "first_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-21",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "118254",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007274A",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33006530A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.