Individual provider Active NPI

Jared Vedros, D.O.

  • Emergency Medicine Physician
  • Anchorage, AK
National Provider Identifier
1811370307
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
7660 Issued in GA
Practice address
786 D St
Anchorage, AK 98505
Phone
(907) 384-0600
NPI assigned
Jul 2, 2015
Last updated
Dec 7, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 134734 AK
Emergency Medicine Physician 207P00000X 7660 GA Primary

Addresses

Primary practice location

786 D St
Anchorage, AK 98505

Mailing address

20113 Highland Ridge Dr
Eagle River, AK 99577-8845
Phone (719) 651-0044

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190114001003 AK Practitioner - Emergency Medicine 5991059990 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Matsu Emergency Medicine Physicians CorpGroup PAC ID 1557251022, 18 clinicians

Practice addresses (Care Compare)

2500 S Woodworth Loop
Palmer, AK 99645-8984
Phone (907) 861-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.48 of 100Reported as individual
Quality
100
Improvement activities
0
Cost
100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
134734AKMDEmergency Medicine Physician
7660GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Emergency Medicine Associates Single Specialty CurrentSince Nov 1, 2018 Accepting new patients
Mat-Su Emergency Medicine Physicians Corp Single Specialty CurrentSince Jan 1, 2019 Accepting new patients
Golden Heart Emergency Physicians, Inc. Single Specialty CurrentSince Nov 1, 2018 Accepting new patients

Locations

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

1650 Cowles St
Fairbanks, AK 99701
Phone (907) 452-8181

2500 S Woodworth Loop
Palmer, AK 99645
Phone (907) 861-6000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1811370307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20113 HIGHLAND RIDGE DR",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995778845",
            "telephone_number": "719-651-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "786 D ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "98505",
            "telephone_number": "907-384-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEDROS",
        "first_name": "JARED",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-02",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "AK",
            "license": "134734",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "7660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.