NPIMap

Individual provider Active NPI

Douglas Prevost, M.D.

  • Orthopaedic Surgery Physician
  • Anchorage, AK
National Provider Identifier
1952376022
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MEDS5369 Issued in AK
Practice address
4100 Lake Otis Pkwy Ste 108
Anchorage, AK 99508-5230
Phone
(907) 563-3145
Fax
(833) 464-5196
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MEDS5369 AK Primary

Addresses

Primary practice location

4100 Lake Otis Pkwy Ste 108
Anchorage, AK 99508-5230

Mailing address

4100 Lake Otis Pkwy Ste 108
Anchorage, AK 99508-5230
Phone (907) 563-3145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050815000727 AK Practitioner - Orthopedic Surgery 7618907114 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
State University of New York at Buffalo School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Anchorage Fracture and Orthopaedic Clinic PCGroup PAC ID 7517914187, 33 clinicians
Medical Network of Alaska LLCGroup PAC ID 3072618859, 70 clinicians

Practice addresses (Care Compare)

10928 Eagle River Rd
Suite 150
Eagle River, AK 99577-8078
Phone (907) 694-8085

12350 Industry Way
Suite 110
Anchorage, AK 99515-4301
Phone (907) 563-3145

4100 Lake Otis Pkwy
Anchorage, AK 99508-5230
Phone (907) 563-3145

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.04 of 100Reported as individual
Quality
37.26
Promoting interoperability
100
Improvement activities
40
Cost
76.21

Merit-based Incentive Payment System (MIPS)

Final score
70.59 of 100Reported as group
Quality
83.37
Promoting interoperability
100
Improvement activities
40
Cost
16.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement121
Knee replacement124
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MEDS5369AKMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Network of Alaska, LLC CurrentSince Mar 1, 2023 Accepting new patients
Medical Network of Alaska, LLC Current Accepting new patients
Anchorage Fracture and Orthopaedic Clinic, PC Orthopaedic Surgery CurrentSince Dec 9, 2018 Accepting new patients
Medical Network of Alaska, LLC CurrentSince Mar 1, 2023 Accepting new patients
Anchorage Fracture and Orthopaedic Clinic, PC CurrentSince Mar 1, 2010 Accepting new patients
Medical Network of Alaska, LLC Current Accepting new patients
Galen Hospital Alaska, Inc. Past Accepting new patients
Orthoalaska LLC PastSince Jan 21, 2024 Accepting new patients
Alaska Bone & Joint Institute PC Orthopaedic Surgery Past Accepting new patients

Locations

12350 Industry Way
Ste 110
Anchorage, AK 99515
Phone (907) 206-9114

3831 Piper St
Ste S220
Anchorage, AK 99508
Phone (907) 212-3420

4100 Lake Otis Pkwy
Ste 108
Anchorage, AK 99508
Phone (907) 339-2455

3831 Piper St
Ste 220
Anchorage, AK 99508

4100 Lake Otis Pkwy
Ste 220
Anchorage, AK 99508

3331 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 357-2332

3122 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 864-4625

Interoperability endpoints

  • Direct secure messaging: douglas.prevost.1@27294.direct.athenahealth.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 9

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.

Hospital & facility affiliations 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1952376022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY STE 108",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085230",
            "telephone_number": "907-563-3145",
            "fax_number": "833-464-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY STE 108",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085230",
            "telephone_number": "907-563-3145",
            "fax_number": "833-464-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREVOST",
        "first_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AK",
            "license": "MEDS5369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.