Brent Taylor, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

3517 Issued in AK

Practice address

2490 S Woodworth Loop Ste 400
Palmer, AK 99645-7411

Phone

(907) 745-9400

Fax

(907) 745-9444

NPI assigned

Sep 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mat-Su Surgical Associates Apc

  • Surgery Physician
  • Wasilla, AK
  • NPI 1396849428
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1770685000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 S WOODWORTH LOOP STE 400",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996457411",
            "telephone_number": "907-745-9400",
            "fax_number": "907-745-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 S WOODWORTH LOOP STE 400",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996457411",
            "telephone_number": "907-745-9400",
            "fax_number": "907-745-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AK",
            "license": "3517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11791",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susitna Surgery Center LLC
• Terrence F Svoboda, M.A.
• Roger Lynn Swingle, MD
• Tak-Ming Ko MD, LLC
• Amanda Jo Taylor, D.V.M
• Telerad Account Management of Alaska LLC
• Tender Journeys Matter Behavioral Health LLC
• Darlett Thackeray
• The Birth Center, LLC
• The Center for Birth, LLC

• Surgery Physician in Palmer, AK
• Providers in Palmer, AK by specialty
• Surgery Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.