Individual provider Active NPI

Irene Bulaong

  • Nursing Home Administrator
  • Anchorage, AK
National Provider Identifier
1922295773
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Home AdministratorTaxonomy code 376G00000X
License
741060 Issued in AK
Practice address
1825 Adonis Dr
Anchorage, AK 99515-4511
Phone
(907) 350-3606
NPI assigned
Sep 26, 2007
Last updated
Sep 26, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Home Administrator 376G00000X 741060 AK Primary

Addresses

Primary practice location

1825 Adonis Dr
Anchorage, AK 99515-4511

Mailing address

11615 Frances Elaine Cir
Anchorage, AK 99515-3396

Other identifiers 1

IdentifierTypeStateIssuer
RL2354MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
741060AKMDNursing Home Administrator

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Care of Alaska, LLC Current Accepting new patients
Infinite Care Hospice LLC Current Accepting new patients

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, 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": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1922295773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11615 FRANCES ELAINE CIR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995153396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 ADONIS DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995154511",
            "telephone_number": "907-350-3606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULAONG",
        "first_name": "IRENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "AK",
            "license": "741060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RL2354",
            "state": "AK"
        }
    ],
    "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 Sep 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.