Andrew D Pankow, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3306 Issued in AK

Practice address

3100 Tongass Ave
Ketchikan, AK 99901-5746

Phone

(907) 228-8140

Fax

(907) 228-8440

NPI assigned

Jun 23, 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 2

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

Specialty

Family Practice

Education

University of Wisconsin School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peacehealth 71 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth Ketchikan Medical Center Home Health Home health agency, Ketchikan, AK, CCN 027014
• Peacehealth Ketchikan Medical Center Hospital, Ketchikan, AK, CCN 021311

Merit-based Incentive Payment System (MIPS)

Final score

79.12 of 100Reported as group

Quality

81.91

Promoting interoperability

100

Improvement activities

40

Cost

40.93

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: apankow1998@direct.peacehealth.org

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.

• Peacehealth

  • Critical Access Hospital
  • Ketchikan, AK
  • NPI 1396705539

  AK

  Medicare reassignment Care Compare group NPD
• Peacehealth

  • Diagnostic Radiology Physician
  • Ketchikan, AK
  • NPI 1801965736

  AK, Family Medicine

  Medicare reassignment Care Compare group NPD
• Peacehealth

  • Medicare Defined Swing Bed Hospital Unit
  • Ketchikan, AK
  • NPI 1528544822
  Care Compare group
• Peacehealth

  • Home Health Agency
  • Ketchikan, AK
  • NPI 1760427082
  Care Compare group
• Peacehealth

  • Skilled Nursing Facility
  • Ketchikan, AK
  • NPI 1851336176
  Care Compare group

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

• Peacehealth

  • Critical Access Hospital
  • Ketchikan, AK
  • NPI 1396705539

  Hospital

  Care Compare affiliation
• Peacehealth

  • Home Health Agency
  • Ketchikan, AK
  • NPI 1760427082
  Care Compare affiliation

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192147200000",
    "number": "1790711992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 TONGASS AVE",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015746",
            "telephone_number": "907-228-8300",
            "fax_number": "907-228-8518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 TONGASS AVE",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015746",
            "telephone_number": "907-228-8140",
            "fax_number": "907-228-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANKOW",
        "first_name": "ANDREW",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "3306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON L&I",
            "identifier": "201209",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD33061",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marc Osborne Jr.
• Maicie Oster
• Pacific Pediatrics, LLC
• Cassandra Page
• Russell Page
• Arika Paquette, MPH
• Jennifer M Parsons, NP
• Glenna Patrick
• Mary Beth Patterson, APRN
• Peacehealth

• All providers in Ketchikan, AK
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.