Organization Active NPI

Northern Lights Eye Care Inc.

  • Optometrist
  • Anchorage, AK
National Provider Identifier
1578626859
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
AA122 Issued in AK
Legal business name
NORTHERN LIGHTS EYE CARE INC.
Practice address
401 E Northern Lights Blvd
Suite 102
Anchorage, AK 99503-2814
Phone
(907) 276-3937
Fax
(907) 278-3937
NPI assigned
Dec 18, 2006
Last updated
Feb 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Authorized official

Name
Dr. Stephen Michael Stralka, ODNPI 1346438629
Title
President
Phone
(907) 276-3937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X AA122 AK Primary

Addresses

Primary practice location

401 E Northern Lights Blvd
Suite 102
Anchorage, AK 99503-2814

Mailing address

401 E Northern Lights Blvd
Suite 102
Anchorage, AK 99503-2814
Phone (907) 276-3937

Other identifiers 1

IdentifierTypeStateIssuer
0D11221MedicaidAK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051207000627 AK Part B Supplier - Clinic/Group Practice 6103847025 Receives reassigned benefits from 3 practitioners
Practice locations: Anchorage, AK

National Provider Directory

National Provider Directory

Locations

401 E Northern Lights Blvd
Anchorage, AK 99503
Phone (907) 276-3937

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1578626859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E NORTHERN LIGHTS BLVD",
            "address_2": "SUITE 102",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032814",
            "telephone_number": "907-276-3937",
            "fax_number": "907-278-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E NORTHERN LIGHTS BLVD",
            "address_2": "SUITE 102",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032814",
            "telephone_number": "907-276-3937",
            "fax_number": "907-278-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN LIGHTS EYE CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "STRALKA",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-276-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "AA122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0D11221",
            "state": "AK"
        }
    ],
    "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 Feb 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.