Individual provider Active NPI

Erik Hulebak

  • Physician Assistant
  • Petersburg, AK
National Provider Identifier
1588116586
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
195321 Issued in AK
Practice address
103 Fram St St
Petersburg, AK 99833-0430
Phone
(907) 772-4291
Fax
(907) 772-3085
NPI assigned
Oct 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 57614 MT
Physician Assistant 363A00000X PA2016-0086 NM
Physician Assistant 363A00000X 195321 AK Primary

Addresses

Primary practice location

103 Fram St St
Petersburg, AK 99833-0430

Mailing address

PO Box 589
Petersburg, AK 99833-0589
Phone (907) 772-4291

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220906001929 AK Practitioner - Physician Assistant 7012298086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of New Mexico School of Medicine, 2016
Medicare assignment
May accept Medicare assignment
Group practices
The Petersburg Medical CenterGroup PAC ID 5395730626, 7 clinicians

Practice addresses (Care Compare)

103 Fram St
Petersburg, AK 99833
Phone (907) 772-4291

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57614MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Petersburg Medical Center CurrentSince Sep 1, 2022 Accepting new patients
The Petersburg Medical Center CurrentSince Sep 1, 2022 Accepting new patients

Organizations & group practices 2

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1588116586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 589",
            "city": "PETERSBURG",
            "state": "AK",
            "postal_code": "998330589",
            "telephone_number": "907-772-4291",
            "fax_number": "907-772-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 FRAM ST ST",
            "city": "PETERSBURG",
            "state": "AK",
            "postal_code": "998330430",
            "telephone_number": "907-772-4291",
            "fax_number": "907-772-3085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULEBAK",
        "first_name": "ERIK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-26",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "57614",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2016-0086",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "195321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, AK

Sources for this page

Verify at the official NPI Registry.