NPIMap

Individual provider Active NPI

Wanatsanan Somkanay, NP

  • Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1760040711
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
145453 Issued in AK
Practice address
2211 E Northern Lights Blvd Ste 101
Anchorage, AK 99508-4192
Phone
(907) 279-8486
Fax
(907) 677-5614
NPI assigned
Jun 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 145453 AK Primary

Addresses

Primary practice location

2211 E Northern Lights Blvd Ste 101
Anchorage, AK 99508-4192

Mailing address

2211 E Northern Lights Blvd Ste 101
Anchorage, AK 99508-4192
Phone (907) 279-8486

Other identifiers 1

IdentifierTypeStateIssuer
1004348MedicaidAK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@mpfcak.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190728000022 AK Practitioner - Nurse Practitioner 0042546160 Reassigns benefits to 1 organization
I20230329000298 TX Practitioner - Nurse Practitioner 0042546160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alaska Native Tribal Health ConsortiumGroup PAC ID 6709780265, 605 clinicians

Practice addresses (Care Compare)

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

Hospital & facility affiliations

  • Alaska Native Medical Center Hospital, Anchorage, AK, CCN 020026

Merit-based Incentive Payment System (MIPS)

Final score
90.93 of 100Reported as group
Quality
70.1
Promoting interoperability
100
Improvement activities
40
Cost
83.01

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium CurrentSince Mar 15, 2023 Accepting new patients
Medical Park Family Care, LLC CurrentSince Jul 3, 2019 Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

2211 E Northern Lights Blvd
Anchorage, AK 99508
Phone (907) 257-8176

2211 E Northern Lights Blvd
Ste 101
Anchorage, AK 99508
Phone (907) 279-8486

Organizations & group practices 2

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1760040711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 E NORTHERN LIGHTS BLVD STE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084192",
            "telephone_number": "907-279-8486",
            "fax_number": "907-677-5614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 E NORTHERN LIGHTS BLVD STE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084192",
            "telephone_number": "907-279-8486",
            "fax_number": "907-677-5614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMKANAY",
        "first_name": "WANATSANAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AK",
            "license": "145453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004348",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@mpfcak.com",
            "affiliation": "N",
            "endpointDescription": "credentialing email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "2211 E Northern Lights Blvd Ste 101",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995084192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.