Organization Active NPI

Pioneer Gi Clinic, Apc

  • Gastroenterology Physician
  • Anchorage, AK
National Provider Identifier
1649457581
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
6191 Issued in AK
Legal business name
PIONEER GI CLINIC, APC
Practice address
1200 Airport Heights Dr
Ste 210
Anchorage, AK 99508-2965
Phone
(907) 562-6001
Fax
(907) 562-6002
NPI assigned
Jan 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Authorized official

Name
Dr. Ajay Pabby, MDNPI 1205929163
Title
President
Phone
(509) 818-7500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 6191 AK Primary

Addresses

Primary practice location

1200 Airport Heights Dr
Ste 210
Anchorage, AK 99508-2965

Mailing address

1200 Airport Heights Dr
Ste. 210
Anchorage, AK 99508-2965
Phone (907) 562-6001

Other identifiers 1

IdentifierTypeStateIssuer
MDG033MedicaidAK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080312000484 AK Part B Supplier - Clinic/Group Practice 1759466964 Receives reassigned benefits from 9 practitioners
Practice locations: Anchorage, AK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
02D2335640Pioneer Gi Clinic1200 Airport Heights Dr, Building E, Suite 210, Anchorage, AK 99508RegistrationDec 14, 2027

National Provider Directory

National Provider Directory

Locations

1200 Airport Heights Dr
Ste 210
Anchorage, AK 99508
Phone (907) 263-2200

1200 Airport Heights Dr
Anchorage, AK 99508

1917 Abbott Rd
Ste 103
Anchorage, AK 99507
Phone (907) 770-3224

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652400000000",
    "number": "1649457581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 AIRPORT HEIGHTS DR",
            "address_2": "STE. 210",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082965",
            "telephone_number": "907-562-6001",
            "fax_number": "907-562-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 AIRPORT HEIGHTS DR",
            "address_2": "STE 210",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082965",
            "telephone_number": "907-562-6001",
            "fax_number": "907-562-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER GI CLINIC, APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A",
        "authorized_official_last_name": "PABBY",
        "authorized_official_first_name": "AJAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-818-7500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AK",
            "license": "6191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDG033",
            "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 May 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.