Organization Active NPI

Plastic Surgeons of Alaska, LLC

  • Plastic Surgery Physician
  • Anchorage, AK
National Provider Identifier
1871738674
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PLASTIC SURGEONS OF ALASKA, LLC
Practice address
301 W Northern Lights Blvd Ste 110
Anchorage, AK 99503-2652
Phone
(907) 563-2002
NPI assigned
Dec 8, 2008
Last updated
May 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Authorized official

Name
John Cole
Title
Business Manager
Phone
(907) 563-2002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X NU Primary

Addresses

Primary practice location

301 W Northern Lights Blvd Ste 110
Anchorage, AK 99503-2652

Mailing address

301 W Northern Lights Blvd Ste 110
Anchorage, AK 99503-2652
Phone (907) 563-2002

Other names 1

  • PSAK Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090527000495 AK Part B Supplier - Clinic/Group Practice 8921157793 Receives reassigned benefits from 6 practitioners
Practice locations: Anchorage, AK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
02D2345318Plastic Surgeons of Alaska301 W Northern Lights Blvd, Ste 110, Anchorage, AK 99503Certificate of waiverJun 7, 2028

National Provider Directory

National Provider Directory

Locations

2741 Debarr Rd
Ste C215
Anchorage, AK 99508
Phone (907) 563-2002

301 W Northern Lights Blvd
Ste 110
Anchorage, AK 99503
Phone (907) 563-2002

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779840000000",
    "number": "1871738674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W NORTHERN LIGHTS BLVD STE 110",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032652",
            "telephone_number": "907-563-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W NORTHERN LIGHTS BLVD STE 110",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032652",
            "telephone_number": "907-563-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGEONS OF ALASKA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-08",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "907-563-2002"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PSAK",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "PSAK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.