Jan H Nyboer, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD1135 Issued in AK

Practice address

9350 Independence Dr
Anchorage, AK 99507

Phone

(907) 561-1167

Fax

(907) 561-7051

NPI assigned

Aug 29, 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southside Eyecare, LLC

  • Optometrist
  • Anchorage, AK
  • NPI 1245403377
  NPD

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186012800000",
    "number": "1811005606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9350 INDEPENDENCE DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99507",
            "telephone_number": "907-561-1167",
            "fax_number": "907-561-7051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 INDEPENDENCE DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99507",
            "telephone_number": "907-561-1167",
            "fax_number": "907-561-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYBOER",
        "first_name": "JAN",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AK",
            "license": "MD1135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1811005606",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD1135",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joy Nunnery-Bates
• Cardell J Nunnery
• Nustart Assisted Living
• Kathleen S Nuttle, PA-C
• Eseneiaso Nuusolia
• Ashlee Nye, DDS
• Jirleen Nyel
• Kristin Nygren
• Joseph Nyholm, RD
• Marie Nying

• Ophthalmology Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Ophthalmology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.