Active NPI
Matija Elizabeth Meenaghan, P.A.-C
- Medical Physician Assistant
- Fairbanks, AK
National Provider Identifier
1881826394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 2390
- Practice address
- 1275 Sadler Way
Ste. 101
Fairbanks, AK 99701-3175 - Phone
- (907) 374-7911
- NPI assigned
- Aug 17, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 498 | AK | |
| Medical Physician Assistant | 363AM0700X | 2390 | AK | Primary |
Addresses
Primary practice location
1275 Sadler Way
Ste. 101
Fairbanks, AK 99701-3175
Mailing address
1275 Sadler Way
Ste. 101
Fairbanks, AK 99701-4609
Phone (907) 374-7744
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2390 | AK | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tanana Chiefs Conference | Current | Accepting new patients | |
| Steese Immediate Care | Past | Accepting new patients |
Locations
1717 W Cowles St
Fairbanks, AK 99701
Phone (907) 452-6682
Interoperability endpoints
- matija.meenaghan.1@31576.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Urgent Care Clinic/Center
- Fairbanks, AK
- NPI 1285922104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422489600000",
"number": "1881826394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1275 SADLER WAY",
"address_2": "STE. 101",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997014609",
"telephone_number": "907-374-7744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 SADLER WAY",
"address_2": "STE. 101",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997013175",
"telephone_number": "907-374-7911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEENAGHAN",
"first_name": "MATIJA",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "P.A.-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-17",
"last_updated": "2015-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AK",
"license": "498",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "AK",
"license": "2390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.