Individual provider Active NPI

Austin Keita Hummel, PA-C

  • Physician Assistant
  • Anchorage, AK
National Provider Identifier
1720754161
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
246355 Issued in AK
Practice address
4100 Lake Otis Pkwy Ste 220
Anchorage, AK 99508-5230
Phone
(907) 563-3145
Fax
(833) 464-5196
NPI assigned
Aug 17, 2021
Last updated
Sep 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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 246355 AK Primary

Addresses

Primary practice location

4100 Lake Otis Pkwy Ste 220
Anchorage, AK 99508-5230

Mailing address

4100 Lake Otis Pkwy Ste 220
Anchorage, AK 99508-5230
Phone (907) 563-3145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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

Enrollment IDStateProvider typePAC IDDetails
I20240418002642 UT Practitioner - Physician Assistant 8022405323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lincoln Memorial University Medical Department, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians

Practice addresses (Care Compare)

1750 E 3100
Layton, UT 84040-2406
Phone (801) 773-4840

2121 N 1700
Layton, UT 84041-8803
Phone (801) 773-4840

425 S 100
Layton, UT 84041-5356
Phone (801) 773-4840

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
246355AKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Memorial Clinic CurrentSince Jun 1, 2024 Accepting new patients
Peninsula Community Health Services Physician Assistant Past Accepting new patients
Tanner Memorial Clinic Past Accepting new patients
Rosenberg Cooley Metcalf LC Past Accepting new patients

Locations

1750 E 3100 N
Layton, UT 84040
Phone (385) 405-2252

Interoperability endpoints

  • Direct secure messaging: austin.hummel.p1@direct.tannerclinic.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1720754161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY STE 220",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085230",
            "telephone_number": "907-563-3145",
            "fax_number": "833-464-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY STE 220",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085230",
            "telephone_number": "907-563-3145",
            "fax_number": "833-464-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMMEL",
        "first_name": "AUSTIN",
        "middle_name": "KEITA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-17",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "246355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.