Individual provider Active NPI

Trevor Van Oostrom, M.D.

  • Specialist
  • Palmer, AK
National Provider Identifier
1730130014
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
5592 Issued in AK
Practice address
2500 S Woodworth Loop
Palmer, AK 99645-8984
Phone
(907) 745-0374
Fax
(907) 745-0200
NPI assigned
May 12, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 5592 AK Primary

Addresses

Primary practice location

2500 S Woodworth Loop
Palmer, AK 99645-8984

Mailing address

PO Box 853
Palmer, AK 99645-0853
Phone (907) 745-0374

Other identifiers 4

IdentifierTypeStateIssuer
MDG417MedicaidAK
MD0271MedicaidAK
P00283147OtherAKVANOO RAILROAD MCR#
CI9459OtherAKGROUPS RR MCR#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5592AKMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Care Associates, PC PastSince Dec 9, 2019 Accepting new patients

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, 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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1730130014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 853",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996450853",
            "telephone_number": "907-745-0374",
            "fax_number": "907-745-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S WOODWORTH LOOP",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996458984",
            "telephone_number": "907-745-0374",
            "fax_number": "907-745-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN OOSTROM",
        "first_name": "TREVOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AK",
            "license": "5592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDG417",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD0271",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VANOO RAILROAD MCR#",
            "identifier": "P00283147",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUPS RR MCR#",
            "identifier": "CI9459",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.