Individual provider Active NPI

Mary Patricia Demers, DO

  • Internal Medicine Physician
  • Anchorage, AK
National Provider Identifier
1649236084
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
AA3359 Issued in AK
Practice address
3340 Providence Dr
Ste 466
Anchorage, AK 99508-4616
Phone
(907) 263-2200
Fax
(907) 276-0366
NPI assigned
Apr 25, 2006
Last updated
Jul 20, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X AA3359 AK Primary
Occupational Medicine Physician 2083X0100X AA3359 AK

Addresses

Primary practice location

3340 Providence Dr
Ste 466
Anchorage, AK 99508-4616

Mailing address

3340 Providence Dr
Ste 466
Anchorage, AK 99508-4616
Phone (907) 263-2200

Other identifiers 1

IdentifierTypeStateIssuer
MD2204MedicaidAK

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070524000375 AK Practitioner - Internal MedicinePractitioner - Osteopathic Manipulative Medicine 7012014194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Osteopathic Manipulative Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

10928 Eagle River Rd
Suite 150
Eagle River, AK 99577-8078
Phone (907) 694-8085

4001 Dale St
Suite 201
Anchorage, AK 99508-5445
Phone (907) 263-2200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
AA3359AKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary P. Demers, D.O., & Associates, LLC Internal Medicine CurrentSince Jun 20, 2007 Accepting new patients

Locations

3340 Providence Dr
Ste 466
Anchorage, AK 99508
Phone (907) 212-5067

3340 Providence Dr
Ste A466
Anchorage, AK 99508
Phone (907) 263-2200

4001 Dale St
Ste 201
Anchorage, AK 99508
Phone (907) 263-2200

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJJJCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/CJJJCD/Endpoint/CJJJCD

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.

Hospital & facility affiliations 5

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184889600000",
    "number": "1649236084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 PROVIDENCE DR",
            "address_2": "STE 466",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084616",
            "telephone_number": "907-263-2200",
            "fax_number": "907-276-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 PROVIDENCE DR",
            "address_2": "STE 466",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084616",
            "telephone_number": "907-263-2200",
            "fax_number": "907-276-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMERS",
        "first_name": "MARY",
        "middle_name": "PATRICIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2007-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "AA3359",
            "primary": true
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "AK",
            "license": "AA3359",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD2204",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.