Creed K Mamikunian, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

AA2517 Issued in AK

Practice address

2401 E 42ND Ave
Suite 206
Anchorage, AK 99508-5205

Phone

(907) 562-1860

Fax

(907) 562-1865

NPI assigned

Jul 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Otolaryngology

Education

Tulane University School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Creed Mamikunian, MD

  • Otolaryngology Physician
  • Anchorage, AK
  • NPI 1609434497
  NPD (past) Authorized official

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

• Providence Health & Services Washington

  dba Providence Alaska Medical Center

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119
  Care Compare affiliation

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639102254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 E 42ND AVE",
            "address_2": "SUITE 206",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085205",
            "telephone_number": "907-562-1860",
            "fax_number": "907-562-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 E 42ND AVE",
            "address_2": "SUITE 206",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085205",
            "telephone_number": "907-562-1860",
            "fax_number": "907-562-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMIKUNIAN",
        "first_name": "CREED",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AK",
            "license": "AA2517",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A48276",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD2517",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ailua Mamea-Neufeldt
• Alisi Mamea
• Brea Mamea
• Isabella Mamea
• Vai Mamea
• Willy Raissa Mamtchueng
• Chun Piu Man, D.D.S
• Paul Kenneth R Manabat, OTD, OTR/L
• Rowena Mandanas, DDS
• Angela J Manderfeld, MS, RD, CDE

• Otolaryngology Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Otolaryngology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.