Individual provider Active NPI

James F Walery, M.D.

  • Family Medicine Physician
  • Unalaska, AK
National Provider Identifier
1851366207
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
102832 Issued in AK
Practice address
34 Lavelle Court
Unalaska, AK 99685
Phone
(907) 581-1202
NPI assigned
Feb 21, 2006
Last updated
Aug 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 3967 SD
Family Medicine Physician 207Q00000X 3967 SD
Family Medicine Physician 207Q00000X 102832 AK Primary

Addresses

Primary practice location

34 Lavelle Court
Unalaska, AK 99685

Mailing address

PO Box 4105
Portland, OR 97208-4105
Phone (866) 907-1068

Other practice location 1

1201 E 36th Ave
Anchorage, AK 99508-4372
Phone (907) 562-9229

Other identifiers 2

IdentifierTypeStateIssuer
5609880MedicaidSD
1636403MedicaidAK

Other names 1

  • Jim Walery Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwalery562195@ak.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, AK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20071211000742 SD Practitioner - Family Practice 8628167814 Reassigns benefits to 3 organizations
I20151207002840 AK Practitioner - Family Practice 8628167814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Sanford School of Medicine of University of South Dakota, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of BrookingsGroup PAC ID 1052307105, 112 clinicians
Iliuliuk Family and Health Services IncGroup PAC ID 5294635165, 9 clinicians
Rural Health Care IncGroup PAC ID 3476447541, shared by 13 NPIs, 156 clinicians

Practice addresses (Care Compare)

300 22ND Ave
Brookings, SD 57006-2480
Phone (605) 692-6351

34 Lavelle Court
Unalaska, AK 99685-0144
Phone (907) 581-1202

34 Lavelle CT
Unalaska, AK 99685-0144

400 22ND Ave
Brookings, SD 57006-2450
Phone (605) 697-9500

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St Marys CurrentSince May 1, 2022 Accepting new patients
Iliuliuk Family and Health Services Inc CurrentSince May 10, 2021 Accepting new patients
Rural Health Care, Inc CurrentSince Jan 25, 2021 Accepting new patients
Avera St Marys Current Accepting new patients
Rural Health Care, Inc. Current Accepting new patients
Rural Health Care, Inc CurrentSince Jan 25, 2021 Accepting new patients
City of Brookings CurrentSince Jan 25, 2021 Accepting new patients
Avera St. Mary's CurrentSince May 1, 2022 Accepting new patients
Center for Family Medicine Family Medicine PastSince Jan 13, 1992 Accepting new patients
Center for Family Medicine Family Medicine PastSince Dec 12, 2021 Accepting new patients
Iliuliuk Family &Health Services, Inc. Past Accepting new patients

Locations

300 22nd Ave
Brookings, SD 57006
Phone (605) 692-6351

400 22nd Ave
Brookings, SD 57006
Phone (605) 692-6236

400 22nd Ave
Ste 1
Brookings, SD 57006
Phone (605) 697-9500

Interoperability endpoints

  • Direct secure messaging: jim.walery@avera.sdhealthlink.net
  • Direct secure messaging: jwalery562195@ak.providencedirect.org

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1851366207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084105",
            "telephone_number": "866-907-1068",
            "fax_number": "425-917-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 LAVELLE COURT",
            "city": "UNALASKA",
            "state": "AK",
            "postal_code": "99685",
            "telephone_number": "907-581-1202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 E 36th Ave",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995084372",
            "country_code": "US",
            "telephone_number": "907-562-9229",
            "fax_number": "907-562-1603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALERY",
        "first_name": "JAMES",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2021-08-11",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "SD",
            "license": "3967",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "3967",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "102832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5609880",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1636403",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwalery562195@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "1201 E 36th Ave",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995084372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JIM",
            "last_name": "WALERY",
            "credential": "NICKNAME",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Unalaska, AK

Sources for this page

Verify at the official NPI Registry.