Individual provider Active NPI

Riley Bennett-Vockner, PA-C

  • Medical Physician Assistant
  • Girdwood, AK
National Provider Identifier
1760736672
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2225 Issued in AK
Practice address
131 Lindblad Ave.
Girdwood, AK 99587-1130
Phone
(907) 783-1355
NPI assigned
Oct 30, 2012
Last updated
Jun 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2225 AK Primary

Addresses

Primary practice location

131 Lindblad Ave.
Girdwood, AK 99587-1130

Mailing address

6931 Chad St
Anchorage, AK 99518-2054
Phone (907) 841-0736

Other practice location 1

306 West 5th Ave
Nome, AK 99762
Phone (907) 443-3311

Other names 1

  • Riley Bennett Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 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

Enrollment IDStateProvider typePAC IDDetails
I20121219000084 AK Practitioner - Physician Assistant 3274693957 Reassigns benefits to 3 organizations
I20200325002934 TX Practitioner - Physician Assistant 3274693957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Girdwood Health Clinic, Inc.Group PAC ID 4688836216, 8 clinicians

Practice addresses (Care Compare)

10928 Eagle River Rd
Eagle River, AK 99577-8078
Phone (907) 694-8085

131 Lindblad Ave
Girdwood, AK 99587-1130
Phone (907) 783-1355

PO Box
Girdwood, AK 99587

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2225AKMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Sound Health Corporation CurrentSince Oct 29, 2012 Accepting new patients
Norton Sound Health Corporation CurrentSince Oct 29, 2012 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Dec 20, 2019 Accepting new patients
Alaska Imaging Associates, LLC Past Accepting new patients
Girdwood Clinic, Inc. Past Accepting new patients

Locations

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

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

Interoperability endpoints

  • Direct secure messaging: riley.bennett-vockner.1@20726.direct.athenahealth.com
  • Direct secure messaging: riley.bennett-vockner.1@8748.direct.athenahealth.com

Organizations & group practices 7

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": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1760736672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6931 CHAD ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995182054",
            "telephone_number": "907-841-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 LINDBLAD AVE.",
            "city": "GIRDWOOD",
            "state": "AK",
            "postal_code": "995871130",
            "telephone_number": "907-783-1355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 West 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Nome",
            "state": "AK",
            "postal_code": "99762",
            "country_code": "US",
            "telephone_number": "907-443-3311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT-VOCKNER",
        "first_name": "RILEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "2225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RILEY",
            "last_name": "BENNETT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Girdwood, AK

Sources for this page

Verify at the official NPI Registry.