Yukon Eyecare Professionals LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

YUKON EYECARE PROFESSIONALS LLC

Practice address

1275 Sadler Way Ste 103
Fairbanks, AK 99701-3175

Phone

(907) 888-8174

NPI assigned

Jan 19, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy Fulk, ODNPI 1134571698

Title

Owner

Phone

(907) 888-8174

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeremy Fulk

  • Optometrist
  • Fairbanks, AK
  • NPI 1134571698
  Medicare reassignment Care Compare group NPD Authorized official
• Scott Gabreski, O.D.

  • Optometrist
  • Fairbanks, AK
  • NPI 1013466796
  Medicare reassignment Care Compare group NPD
• Michael Isaac Biscoe, OD

  • Optometrist
  • Aurora, CO
  • NPI 1639818578

  AK

  Medicare reassignment
• Sandra Maria Rugama, OD

  • Optometrist
  • Louisville, CO
  • NPI 1093398570

  AK

  Medicare reassignment

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1811649064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 SADLER WAY STE 103",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013175",
            "telephone_number": "907-888-8174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 SADLER WAY STE 103",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013175",
            "telephone_number": "907-888-8174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YUKON EYECARE PROFESSIONALS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "FULK",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-888-8174",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon L Young, NP
• Jennifer Young, PT
• Jessica A Young, MD
• Keira Youngblood
• Ambria Marie Younker, PA
• Ekaterina Yuvasheva, RPH
• Zachery Jones
• Ira Zaczkowski
• Charli Makayla Cheyenne Zahm
• Leah Nicole Zairis, RBT

• Optometrist in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Optometrist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.