NPIMap

Individual provider Active NPI

Brent Alan Ursel, PAC

  • Physician Assistant
  • Seward, AK
National Provider Identifier
1679637011
Registry record updated Mar 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA202 Issued in AK
Practice address
11724 Seward Hwy
Ste D
Seward, AK 99664-9714
Phone
(907) 224-8733
Fax
(907) 224-8734
NPI assigned
Dec 20, 2006
Last updated
Mar 31, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA202 AK Primary

Addresses

Primary practice location

11724 Seward Hwy
Ste D
Seward, AK 99664-9714

Mailing address

11724 Seward Hwy
Ste D
Seward, AK 99664-9714
Phone (907) 224-8733

Other identifiers 5

IdentifierTypeStateIssuer
043650384OtherAKOTHER PAR & NONPAR PAYERS
BCBSOtherAK043650384
043650384OtherAKPREMARA
MD22813MedicaidAK
043650384OtherAKNORTHWEST NPI SERVICES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101020000286 AK Practitioner - Physician Assistant 6608779723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11724 Seward Hwy
Suite D
Seward, AK 99664-9708
Phone (907) 224-8733

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
202AKMDOptometrist
PA202AKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Interior Community Health Center Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206921600000",
    "number": "1679637011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11724 SEWARD HWY",
            "address_2": "STE D",
            "city": "SEWARD",
            "state": "AK",
            "postal_code": "996649714",
            "telephone_number": "907-224-8733",
            "fax_number": "907-224-8734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11724 SEWARD HWY",
            "address_2": "STE D",
            "city": "SEWARD",
            "state": "AK",
            "postal_code": "996649714",
            "telephone_number": "907-224-8733",
            "fax_number": "907-224-8734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URSEL",
        "first_name": "BRENT",
        "middle_name": "ALAN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2008-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "PA202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER PAR & NONPAR PAYERS",
            "identifier": "043650384",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "043650384",
            "identifier": "BCBS",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMARA",
            "identifier": "043650384",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD22813",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTHWEST NPI SERVICES",
            "identifier": "043650384",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seward, AK

Sources for this page

Verify at the official NPI Registry.