Peter O Mjos, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1553 Issued in AK

Practice address

3300 Providence Dr
Suite B314
Anchorage, AK 99508-4690

Phone

(907) 212-3420

NPI assigned

Oct 20, 2006

Last updated

Sep 9, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Providence Health & Services- Washington

  dba Providence Medical Group Alaska

  • Critical Care Medicine (Internal Medicine) Physician
  • Anchorage, AK
  • NPI 1093956278
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1700968344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 196276",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995196276",
            "telephone_number": "907-212-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 PROVIDENCE DR",
            "address_2": "SUITE B314",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084690",
            "telephone_number": "907-212-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MJOS",
        "first_name": "PETER",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "1553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD15151",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE MD GROUP #",
            "identifier": "162616",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Mitton
• Erika K Mitton
• Nancy Mixayphon
• Jessica Marie Mixon, LPC
• Ryan Scott Mizelle
• MM LLC
• Amelia Moananu
• Magnolia Moananu
• Michel Moandal
• Desiree Leeann Mobeck

• Family Medicine Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.