Individual provider Active NPI

Daron Dykema, MD

  • Family Medicine Physician
  • Anchorage, AK
National Provider Identifier
1720094220
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6031 Issued in AK
Practice address
1201 E 36TH Ave
Anchorage, AK 99508-4372
Phone
(907) 562-9229
Fax
(907) 561-4806
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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 6031 AK Primary

Addresses

Primary practice location

1201 E 36TH Ave
Anchorage, AK 99508-4372

Mailing address

PO Box 4105
Portland, OR 97208-4105
Phone (866) 907-1068

Other identifiers 1

IdentifierTypeStateIssuer
1012508MedicaidAK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ddykema8041@ak.providencedirect.org

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070906000751 AK Practitioner - Family PracticePractitioner - General Practice 2365535333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
Loma Linda University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 E 36TH Ave
Anchorage, AK 99508-4372
Phone (907) 562-9229

910 Compassion Cir
Anchorage, AK 99504-1645
Phone (907) 212-9100

920 Compassion Cir
Anchorage, AK 99504-1645
Phone (907) 212-9200

Hospital & facility affiliations

  • Providence at Home With Compassus HH Anchorage Home health agency, Anchorage, AK, CCN 027001
  • Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6031AKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Mar 16, 2020 Accepting new patients

Locations

1201 E 36th Ave
Anchorage, AK 99508
Phone (907) 562-9229

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

920 Compassion Cir
Anchorage, AK 99504
Phone (907) 212-9200

Organizations & group practices 1

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 2

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1720094220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084105",
            "telephone_number": "866-907-1068",
            "fax_number": "425-917-9141"
        },
        {
            "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": "907-561-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKEMA",
        "first_name": "DARON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "6031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012508",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddykema8041@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "1201 E 36th Ave",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995084372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.