NPIMap

Organization Active NPI

Alaska Specialty Hospital, LLC

Doing business as Providence St Elias Rehabilitation Unit

  • Rehabilitation Hospital Unit
  • Anchorage, AK
National Provider Identifier
1861045445
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
ALASKA SPECIALTY HOSPITAL, LLC
Doing business as
Providence St Elias Rehabilitation Unit
Practice address
4800 Cordova St
Anchorage, AK 99503-7218
Phone
(907) 561-3333
Fax
(907) 561-3332
NPI assigned
Jul 22, 2019
Last updated
Sep 9, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
ALASKA SPECIALTY HOSPITAL, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Authorized official

Name
Donald Wayne Anderson Jr.
Title
Assistant Secretary of Enrollments
Phone
(425) 358-9786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X Primary

Addresses

Primary practice location

4800 Cordova St
Anchorage, AK 99503-7218

Mailing address

PO Box 31001 - 4166
Pasadena, CA 91110-4166
Phone (907) 561-3333

Other names 1

  • PROVIDENCE ST ELIAS REHABILITATION UNIT Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191001001511 AK Part A Provider - Hospital 7810992203 Practice locations: Anchorage, AK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861045445. Details of each certification follow.

Hospital certification: CCN 02TA01

Legal name
ALASKA SPECIALTY HOSPITAL, LLC
Doing business as
PROVIDENCE ST ELIAS SPECIALTY HOSPITAL
Organization structure
LLCProprietary
Incorporated
May 9, 2005 in AK
Enrollment address
4800 Cordova St
Anchorage, AK 99503-7218
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
St Elias Specialty HospitalCCN 02TA01 · All quality measures
Ownership
Non-profit
Certified
Jan 1, 2020

National Provider Directory

National Provider Directory
Tax ID family
Alaska Specialty Hospital LLC2 organizations share this tax ID, including this one
Part of
Alaska Specialty Hospital LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Diane L Hejna Individual Corporate DirectorDirector Jan 1, 2024
Richard S Blair Individual Corporate DirectorDirector Jan 1, 2024
Marvin O'Quinn Individual Corporate DirectorDirector Jan 1, 2024
Linda Buck Individual Corporate DirectorBoard Member Jan 1, 2025
Jessica Kopczynski Oswald Individual W-2 Managing EmployeeAd; Sep 1, 2019
Providence Health & Services - Washington Organization, Renton, WA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Aug 8, 2018 100%
Operational/Managerial Control Aug 8, 2018
Mary E Lyons Individual Corporate DirectorDirector Jan 1, 2024
Phyllis M Hughes Individual Corporate DirectorDirector Jan 1, 2024
Rogelio Riojas Individual Corporate DirectorBoard Member Jan 1, 2025
James Martin Individual Corporate OfficerAsst Treasurer Jan 1, 2024
Charles Wallace Sorenson Individual Corporate DirectorDirector Jan 1, 2024
Donald Wayne Anderson Individual Corporate OfficerAssistant Secretary of Enrollments Aug 1, 2021
Gregory David Hoffman Individual Corporate OfficerCfo & Treasurer Jan 1, 2024
Isiaah D Crawford Individual Corporate DirectorDirector Jan 1, 2024
Donna Markham Individual Corporate DirectorDirector Jan 1, 2024
Michael W Murphy Individual Corporate DirectorDirector Jan 1, 2024
Providence Health & Services Organization, Renton, WA Corporation, Non-profit Other Jul 1, 2016
Mary Beth Kingston Individual Corporate DirectorDirector Jan 1, 2024
Eric D Sprunk Individual Corporate DirectorDirector Jan 1, 2024
Anna R Newsom Individual Corporate OfficerCorporate Secretary Jan 1, 2024
Darryl Elmouchi Individual Corporate OfficerPresident/Ceo Apr 1, 2025
Karin Dufault Individual Corporate DirectorBoard Member Jan 1, 2025
Providence St. Joseph Health Organization, Renton, WA Corporation, Non-profit Other Jul 1, 2016

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 139

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 139

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 21

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1861045445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001 - 4166",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911104166",
            "telephone_number": "907-561-3333",
            "fax_number": "907-561-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 CORDOVA ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037218",
            "telephone_number": "907-561-3333",
            "fax_number": "907-561-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALASKA SPECIALTY HOSPITAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALASKA SPECIALTY HOSPITAL, LLC",
        "enumeration_date": "2019-07-22",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY OF ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROVIDENCE ST ELIAS REHABILITATION UNIT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.