Active NPI
Irene Bulaong
- Nursing Home Administrator
- Anchorage, AK
National Provider Identifier
1922295773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Home Administrator
- License
- 741060
- Practice address
- 1825 Adonis Dr
Anchorage, AK 99515-4511 - Phone
- (907) 350-3606
- NPI assigned
- Sep 26, 2007
- Last updated
- Sep 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RL2354 | Medicaid | AK |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 741060 | AK | MD | Nursing Home Administrator |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Community Based Hospice Care Agency
- Anchorage, AK
- NPI 1972488211
-
- Home Health Agency
- Anchorage, AK
- NPI 1366865859
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.