Mikayla Desoto, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

171489 Issued in AK

Practice address

4320 Diplomacy Dr Ste 2300
Anchorage, AK 99508-5925

Phone

(907) 729-3300

NPI assigned

Sep 12, 2019

Last updated

Mar 24, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, AK2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services- WashingtonGroup PAC ID 1557408176, 219 clinicians

Anchorage Neighborhood Health Center IncGroup PAC ID 0941107288, shared by 2 NPIs, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: mdesoto3795762@ak.providencedirect.org
• Direct secure messaging: mikayla.desoto.1@20726.direct.athenahealth.com

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
  Medicare reassignment Care Compare group
• Camai Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Naknek, AK
  • NPI 1679718019
  Medicare reassignment
• Providence Health & Services-Washington

  dba Providence Medical Group Alaska

  • Community/Behavioral Health Agency
  • Anchorage, AK
  • NPI 1841814795
  NPD
• Alaska Imaging Associates, LLC

  dba Northern Lights Imaging

  • Diagnostic Radiology Physician
  • Anchorage, AK
  • NPI 1063466688
  NPD (past)
• Bristol Bay Borough

  dba Camai Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Naknek, AK
  • NPI 1629105804
  NPD (past)
• Eastern Aleutian Tribes, Inc

  • Community Health Clinic/Center
  • King Cove, AK
  • NPI 1649332446
  NPD (past)

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

• Providence Health & Services Washington

  dba Providence Alaska Medical Center

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119
  Care Compare affiliation

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1720638737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 DIPLOMACY DR STE 2300",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085925",
            "telephone_number": "907-729-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 DIPLOMACY DR STE 2300",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085925",
            "telephone_number": "907-729-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESOTO",
        "first_name": "MIKAYLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-12",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "171489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Hunnewell Deschweinitz, M.D
• Shamera Blair Desinger, RN
• Danni Marquis Desjarlais
• Thelma Desjarlais
• Brian Desmond, PA
• Howard Frederick Detwiler Jr., M.D.
• Rebecca Marie Deugaw
• Bernadette Shold Deveny
• Erika Deveny
• Stephen Deveny

• 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 24, 2021; 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.