Organization Active NPI

Jeffrey W. Molloy, M.D, P.C.

  • Gastroenterology Physician
  • Anchorage, AK
National Provider Identifier
1669887428
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
7988 Issued in AK
Legal business name
JEFFREY W. MOLLOY, M.D, P.C.
Practice address
3851 Piper St
Suite U-466
Anchorage, AK 99508-4684
Phone
(907) 569-1333
Fax
(907) 569-1433
NPI assigned
Jun 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Authorized official

Name
Dr. Jeffrey William Molloy, M.D.NPI 1306833611
Title
President
Phone
(907) 569-1333

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 7988 AK Primary

Addresses

Primary practice location

3851 Piper St
Suite U-466
Anchorage, AK 99508-4684

Mailing address

3851 Piper St
Suite U-466
Anchorage, AK 99508-4684
Phone (907) 569-1333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140917000265 AK Part B Supplier - Clinic/Group Practice 3779702139 Receives reassigned benefits from 1 practitioner
Practice locations: Anchorage, AK; Eagle River, AK

National Provider Directory

National Provider Directory

Locations

3851 Piper St
Anchorage, AK 99508
Phone (907) 569-1333

17101 Snowmobile Ln
Ste 204
Eagle River, AK 99577
Phone (907) 569-1333

Practitioners & affiliated clinicians

Practitioners 1

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": "1404086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404086400000",
    "number": "1669887428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 PIPER ST",
            "address_2": "SUITE U-466",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084684",
            "telephone_number": "907-569-1333",
            "fax_number": "907-569-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 PIPER ST",
            "address_2": "SUITE U-466",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084684",
            "telephone_number": "907-569-1333",
            "fax_number": "907-569-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY W. MOLLOY, M.D, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-30",
        "last_updated": "2014-06-30",
        "status": "A",
        "authorized_official_last_name": "MOLLOY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-569-1333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AK",
            "license": "7988",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.