Individual provider Active NPI

Craig Donald Rennard, O.D.

  • Optometrist
  • Anchorage, AK
National Provider Identifier
1881788412
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
273 Issued in AK
Practice address
4341 Tudor Centre Dr
Anchorage, AK 99508-5904
Phone
(907) 729-8500
Fax
(907) 729-8501
NPI assigned
Oct 3, 2006
Last updated
Jul 2, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 273 AK Primary

Addresses

Primary practice location

4341 Tudor Centre Dr
Anchorage, AK 99508-5904

Mailing address

4341 Tudor Centre Dr
Anchorage, AK 99508-5904
Phone (907) 729-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090217000737 TX Practitioner - Optometry 0648335166 Reassigns benefits to 1 organization
I20200303001512 AK Practitioner - Optometry 0648335166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2217 E Tudor Rd
Anchorage, AK 99507-1068
Phone (907) 917-9938

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rennard Eyecare, LLC Optometrist CurrentSince Dec 22, 2019 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Jun 8, 2014 Accepting new patients
Southcentral Foundation Past Accepting new patients
Southcentral Foundation Past Accepting new patients
Southcentral Foundation Past Accepting new patients

Locations

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

600 E Northern Lights Blvd
Ste 136B
Anchorage, AK 99503
Phone (907) 258-6333

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1881788412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4341 TUDOR CENTRE DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085904",
            "telephone_number": "907-729-8500",
            "fax_number": "907-729-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4341 TUDOR CENTRE DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085904",
            "telephone_number": "907-729-8500",
            "fax_number": "907-729-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNARD",
        "first_name": "CRAIG",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.