Individual provider Active NPI

Regina Fiacco, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Anchorage, AK
National Provider Identifier
1871955591
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
105484 Issued in AK
Practice address
4100 Lake Otis Pkwy Ste 108
Anchorage, AK 99508-5230
Phone
(907) 563-3145
Fax
(833) 464-5196
NPI assigned
Mar 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 105484 AK Primary

Addresses

Primary practice location

4100 Lake Otis Pkwy Ste 108
Anchorage, AK 99508-5230

Mailing address

4100 Lake Otis Pkwy Ste 108
Anchorage, AK 99508-5230
Phone (907) 563-3145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190911002167 AK Practitioner - Podiatry 4486983731 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Anchorage Fracture and Orthopaedic Clinic PCGroup PAC ID 7517914187, 33 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Medical Network of Alaska LLCGroup PAC ID 3072618859, 70 clinicians

Practice addresses (Care Compare)

12350 Industry Way
Suite 110
Anchorage, AK 99515-4301
Phone (907) 563-3145

1700 E Bogard Rd
Suite B203
Wasilla, AK 99654-6570
Phone (907) 921-5088

4100 Lake Otis Pkwy
Anchorage, AK 99508-5230
Phone (907) 563-3145

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue52
Removal of skin lesions1-10
Removal of nail tissue336
Removal or shaving of skin growth96

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105484AKMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Network of Alaska, LLC Current Accepting new patients
Medical Network of Alaska, LLC CurrentSince Mar 1, 2023 Accepting new patients
Medical Network of Alaska, LLC Current Accepting new patients
Anchorage Fracture and Orthopaedic Clinic, PC CurrentSince Oct 1, 2022 Accepting new patients
Medical Network of Alaska, LLC CurrentSince Mar 1, 2023 Accepting new patients
Anchorage Fracture and Orthopaedic Clinic, PC CurrentSince Oct 1, 2022 Accepting new patients

Locations

4100 Lake Otis Pkwy
Ste 108
Anchorage, AK 99508
Phone (907) 339-2455

4100 Lake Otis Pkwy
Ste 220
Anchorage, AK 99508

12350 Industry Way
Ste 110
Anchorage, AK 99515
Phone (907) 206-9114

17025 Snowmobile Ln
Ste 102
Eagle River, AK 99577
Phone (907) 357-2800

3331 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 357-2332

3122 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 864-4625

Interoperability endpoints

  • Direct secure messaging: regina.fiacco.1@27294.direct.athenahealth.com
  • Direct secure messaging: regina.fiacco.1@33745.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1871955591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY STE 108",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085230",
            "telephone_number": "907-563-3145",
            "fax_number": "833-464-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY STE 108",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085230",
            "telephone_number": "907-563-3145",
            "fax_number": "833-464-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIACCO",
        "first_name": "REGINA",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AK",
            "license": "105484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.