Individual provider Active NPI

Rachel Alice Samuelson, MD

  • Family Medicine Physician
  • Anchorage, AK
National Provider Identifier
1659635993
Registry record updated Feb 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6540 Issued in AK
Practice address
1201 E 36TH Ave
Anchorage, AK 99508-4372
Phone
(907) 562-9229
Fax
(907) 212-6062
NPI assigned
Jul 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6540 AK Primary

Addresses

Primary practice location

1201 E 36TH Ave
Anchorage, AK 99508-4372

Mailing address

3760 Piper St
Suite 1060
Anchorage, AK 99508-4665
Phone (907) 212-6522

Other identifiers 1

IdentifierTypeStateIssuer
MD1628MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150804003714 AK Practitioner - General Practice 4587818943 Reassigns benefits to 1 organization
I20151029002865 AK Practitioner - Family Practice 4587818943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4951 Business Park Blvd
Anchorage, AK 99503-7174
Phone (907) 743-7200

Hospital & facility affiliations

  • Ancora Home Health & Hospice Home health agency, Wasilla, AK, CCN 027008
  • Alaskan Home Health, Inc Home health agency, Anchorage, AK, CCN 027034
  • Providence at Home With Compassus HH Anchorage Home health agency, Anchorage, AK, CCN 027001
  • Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001
  • Alaska Regional Hospital Hospital, Anchorage, AK, CCN 020017

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anchorage Neighborhood Health Center Inc Family Medicine CurrentSince Oct 19, 2015 Accepting new patients
Anchorage Neighborhood Health Center, Inc. CurrentSince Oct 19, 2015 Accepting new patients

Locations

4951 Business Park Blvd
Anchorage, AK 99503
Phone (907) 743-7200

Interoperability endpoints

  • Direct secure messaging: rsamuelson132059@ak.providencedirect.org

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 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": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360281600000",
    "number": "1659635993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 PIPER ST",
            "address_2": "SUITE 1060",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084665",
            "telephone_number": "907-212-6522",
            "fax_number": "907-212-6593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E 36TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084372",
            "telephone_number": "907-562-9229",
            "fax_number": "907-212-6062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELSON",
        "first_name": "RACHEL",
        "middle_name": "ALICE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2013-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "6540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD1628",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.