Organization Active NPI

Capitolmed LLC

Doing business as Polaris Healthcare

  • Internal Medicine Physician
  • Ketchikan, AK
National Provider Identifier
1770131930
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CAPITOLMED LLC
Doing business as
Polaris Healthcare
Practice address
25 Jefferson Way
Suite 102B
Ketchikan, AK 99901-5953
Phone
(907) 247-7827
Fax
(973) 215-2052
NPI assigned
Aug 30, 2019
Last updated
Dec 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Authorized official

Name
Mr. Kevin A Hall, M.D.NPI 1467708271
Title
Owner / Physician
Phone
(907) 247-7827

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

25 Jefferson Way
Suite 102B
Ketchikan, AK 99901-5953

Mailing address

25 Jefferson Way Ste 102B
Ketchikan, AK 99901-5953
Phone (907) 247-7827

Other identifiers 1

IdentifierTypeStateIssuer
1700612MedicaidAK

Other names 1

  • Polaris Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191118002337 AK Part B Supplier - Clinic/Group Practice 1052743705 Receives reassigned benefits from 1 practitioner
Practice locations: Ketchikan, AK

National Provider Directory

National Provider Directory

Locations

25 Jefferson Way
Ste 102B
Ketchikan, AK 99901
Phone (907) 247-7827

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1770131930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 JEFFERSON WAY STE 102B",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015953",
            "telephone_number": "907-247-7827",
            "fax_number": "973-215-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 JEFFERSON WAY",
            "address_2": "SUITE 102B",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015953",
            "telephone_number": "907-247-7827",
            "fax_number": "973-215-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITOLMED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-30",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER / PHYSICIAN",
        "authorized_official_telephone_number": "907-247-7827",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700612",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Polaris Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ketchikan, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.