NPIMap

Organization Active NPI

Maniilaq Association

Doing business as Maniilaq Health Center

  • Rural Acute Care Hospital
  • Kotzebue, AK
National Provider Identifier
1861698805
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
234051 Issued in AK
Legal business name
MANIILAQ ASSOCIATION
Doing business as
Maniilaq Health Center
Practice address
436 5TH & Ted Stevens Way
Kotzebue, AK 99752
Phone
(907) 442-3321
Fax
(907) 442-7250
NPI assigned
Jun 26, 2007
Last updated
Dec 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Authorized official

Name
Paul Hanson
Title
Administrator
Phone
(907) 442-3321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X 234051 AK Primary

Addresses

Primary practice location

436 5TH & Ted Stevens Way
Kotzebue, AK 99752

Mailing address

PO Box 43
Kotzebue, AK 99752-0043
Phone (907) 442-3321

Other identifiers 1

IdentifierTypeStateIssuer
TEZ042OtherAKMEDICARE ID

Other names 1

  • Maniilaq Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041123000372 TX Part B Supplier - Clinic/Group Practice 6103881792 Receives reassigned benefits from 218 practitioners
12 other NPIs on this enrollment
Practice locations: Shungnak, AK; Selawik, AK; PT Hope, AK; Noorvik, AK; Noatak, AK; Kotzebue, AK; Kobuk, AK; Ambler, AK…

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 220

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.

View all 220

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197936000000",
    "number": "1861698805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "997520043",
            "telephone_number": "907-442-3321",
            "fax_number": "907-442-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 5TH & TED STEVENS WAY",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "99752",
            "telephone_number": "907-442-3321",
            "fax_number": "907-442-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANIILAQ ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2007-12-18",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "907-442-3321"
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "AK",
            "license": "234051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "TEZ042",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maniilaq Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kotzebue, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; 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.