Ivy Weakland, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

115459 Issued in AK

Practice address

4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367

Phone

(206) 616-4001

NPI assigned

Jan 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AK, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: advancedpaincentersofalaska.ivyweakland@156078.advancedmd-direct.com

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.

• Alaska Native Tribal Health Consortium

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1437189339

  TX

  Medicare reassignment NPD
• Anchorage Bariatrics, LLC

  • Surgery Physician
  • Anchorage, AK
  • NPI 1174076822
  Medicare reassignment
• MGM Enterprises LLC

  • Pain Medicine (Anesthesiology) Physician
  • Anchorage, AK
  • NPI 1033910195
  Medicare reassignment
• Advanced Pain Centers of Alaska, Inc

  • Pain Medicine (Anesthesiology) Physician
  • Anchorage, AK
  • NPI 1073618583
  NPD (past)

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1902263387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 INDEPENDENCE DR",
            "address_2": "STE 900",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995074686",
            "telephone_number": "907-522-1341",
            "fax_number": "907-522-1343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 11TH AVE NE STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056367",
            "telephone_number": "206-616-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAKLAND",
        "first_name": "IVY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-15",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "115459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Ways, M.D.
• Sabrina Lee Wayt, DPT
• Waythrough Alliance
• WCC Operator LLC
• We Care Daily Clinics LLC
• Melissa Weakland, MD
• Weandmetherapy
• Douglas M Wear, PSYCHOLOGIST
• Joseph M Weatherby, M.A., LMHC
• Rebecca Weatherby, BS, MA

• Medical Physician Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.

Verify at the official NPI Registry.