Alisha Marie Jennings

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

186268 Issued in AK

Practice address

615 E 82ND Ave Ste 204
Anchorage, AK 99518-3159

Phone

(907) 865-8455

Fax

(913) 246-4901

NPI assigned

Aug 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Washington School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anchorage Dermatology and Cosmetics LLCGroup PAC ID 7416288550, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Anchorage Dermatology & Cosmetics, LLC

  • Dermatology Physician
  • Anchorage, AK
  • NPI 1609420215
  Medicare reassignment Care Compare group
• Kindae Dermatology and Aesthetics LLC

  • MOHS-Micrographic Surgery Physician
  • Anchorage, AK
  • NPI 1952143562
  NPD (past)

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1699387746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E 82ND AVE STE 204",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995183159",
            "telephone_number": "907-865-8455",
            "fax_number": "913-246-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E 82ND AVE STE 204",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995183159",
            "telephone_number": "907-865-8455",
            "fax_number": "913-246-4901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 E 82nd Ave Ste 302",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995183159",
            "country_code": "US",
            "telephone_number": "907-865-8455",
            "fax_number": "913-246-4901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "ALISHA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "186268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Lynn Jenkins
• Thomas Dwain Jenkins
• Jennifer Aist Lactation Services
• Jennifer L Hunt Agnp LLC
• Jennifer L. Hunt, Agnp, LLC
• Ann Jennings, MD
• Milagros Vina Jennings
• Adam Jensen, D.D.S.
• Anya Jensen
• Benjamin D Jensen, PHARM. D.

• Physician Assistant in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.