Marcus C Deede, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1761 Issued in AK

Practice address

245 N Binkley St Ste 202
Soldotna, AK 99669-7500

Phone

(907) 714-4521

Fax

(907) 260-4063

NPI assigned

Jan 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Central Peninsula General Hospital Inc

  dba Central Peninsula Family & Pediatrics - Soldotna

  • Rural Acute Care Hospital
  • Soldotna, AK
  • NPI 1295059921
  NPD (past)
• Central Peninsula General Hospital, Inc

  dba Central Peninsula Care Transitions

  • Community/Behavioral Health Agency
  • Soldotna, AK
  • NPI 1073043717
  NPD (past)
• Central Peninsula General Hospital, Inc

  dba Central Peninsula Gastroenterology

  • Gastroenterology Physician
  • Soldotna, AK
  • NPI 1154194819
  NPD (past)
• Central Peninsula General Hospital, Inc

  dba Serenity House Treatment Facility

  • Community/Behavioral Health Agency
  • Kenai, AK
  • NPI 1174122766
  NPD (past)
• Central Peninsula General Hospital, Inc

  dba Diamond Willow Sober Living

  • Community/Behavioral Health Agency
  • Soldotna, AK
  • NPI 1679179204
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1801946066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 N BINKLEY ST STE 202",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697500",
            "telephone_number": "907-714-4521",
            "fax_number": "907-260-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N BINKLEY ST STE 202",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697500",
            "telephone_number": "907-714-4521",
            "fax_number": "907-260-4063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "265 N Binkley St",
            "address_purpose": "LOCATION",
            "city": "Soldotna",
            "state": "AK",
            "postal_code": "996697523",
            "country_code": "US",
            "telephone_number": "907-262-9341",
            "fax_number": "907-262-1545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "230 E Marydale Ave",
            "address_purpose": "LOCATION",
            "city": "Soldotna",
            "state": "AK",
            "postal_code": "996697648",
            "country_code": "US",
            "telephone_number": "907-262-3119",
            "fax_number": "907-262-9290",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "354 Tyee St",
            "address_purpose": "LOCATION",
            "city": "Soldotna",
            "state": "AK",
            "postal_code": "996697657",
            "country_code": "US",
            "telephone_number": "907-714-5870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "362 Tyee St",
            "address_purpose": "LOCATION",
            "city": "Soldotna",
            "state": "AK",
            "postal_code": "996697631",
            "country_code": "US",
            "telephone_number": "907-714-4521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 Hospital Pl",
            "address_purpose": "LOCATION",
            "city": "Soldotna",
            "state": "AK",
            "postal_code": "996696999",
            "country_code": "US",
            "telephone_number": "907-714-4502",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "47480 Kristina Way",
            "address_purpose": "LOCATION",
            "city": "Kenai",
            "state": "AK",
            "postal_code": "996115902",
            "country_code": "US",
            "telephone_number": "907-714-4437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEEDE",
        "first_name": "MARCUS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2021-03-30",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "1761",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AK",
            "license": "1761",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "AK",
            "license": "MEDS1761",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010689",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdeede635753@ak.providencedirect.org",
            "affiliation": "N",
            "endpointDescription": "provider direct messaging address",
            "address_1": "265 N Binkley St",
            "city": "Soldotna",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996697523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Molly Gretchen Davis, LPC, MAC
• Amy Dawn-Day, LPC
• Amanda M Day-Bontly
• Kelly Anne De Sieyes, CDM, CPM
• Cecilia Scott Deatherage, M.S,,CCC-SLP
• Angeline Dove Delgado, LPC
• Caryn Diane Deluca, PA-C
• Hailey J Demello
• Beth Demick, OTR/L
• Denali Asthma & Pulmonary

• Family Medicine Physician in Soldotna, AK
• Providers in Soldotna, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.