Individual provider Active NPI

Ivarene Hurtado, CCC-SLP

  • Speech-Language Pathologist
  • Anchorage, AK
National Provider Identifier
1881357960
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
180807 Issued in AK
Practice address
4441 Diplomacy Dr
Anchorage, AK 99508-5910
Phone
(907) 729-4166
NPI assigned
Oct 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 180807 AK Primary

Addresses

Primary practice location

4441 Diplomacy Dr
Anchorage, AK 99508-5910

Mailing address

4441 Diplomacy Dr
Anchorage, AK 99508-5910

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211208000304 TX Practitioner - Qualified Speech Language Pathologist 7012307952 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180807AKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southcentral Foundation CurrentSince Dec 1, 2021 Accepting new patients
Southcentral Foundation Current Accepting new patients
Southcentral Foundation Current Accepting new patients
Southcentral Foundation Current Accepting new patients
Southcentral Foundation Current Accepting new patients
Southcentral Foundation CurrentSince Dec 1, 2021 Accepting new patients
Southcentral Foundation Current Accepting new patients
Southcentral Foundation Current Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Dec 1, 2021 Accepting new patients
Southcentral Foundation Past Accepting new patients

Locations

4330 Elmore Rd
Anchorage, AK 99508
Phone (907) 729-6690

4441 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-2000

755 A St
Anchorage, AK 99501
Phone (907) 272-1255

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

6901 E Tudor Rd
Ste 8
Anchorage, AK 99507
Phone (907) 729-6500

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

225 Eagle St
Anchorage, AK 99501
Phone (907) 729-6550

7033 E Tudor Rd
Anchorage, AK 99507
Phone (907) 729-0000

1021 E 3rd Ave
Anchorage, AK 99501
Phone (907) 729-6342

400 W Benson Blvd
Anchorage, AK 99503
Phone (907) 729-4200

26341 Eklutna Village Rd
Chugiak, AK 99567
Phone (907) 688-6031

1 Flight Line Rd
Port Alsworth, AK 99653
Phone (907) 781-2256

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1881357960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4441 DIPLOMACY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4441 DIPLOMACY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085910",
            "telephone_number": "907-729-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURTADO",
        "first_name": "IVARENE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-15",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AK",
            "license": "180807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 15, 2021; 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.