Active NPI
Suzanne Margaret Milette, PA-C
- Physician Assistant
- Iliamna, AK
National Provider Identifier
1952417792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 467
- Practice address
- 101 Airport Road
Iliamna, AK 99606-9800 - Phone
- (907) 729-8624
- NPI assigned
- Aug 22, 2006
- Last updated
- Dec 20, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 467 | AK | Primary |
Addresses
Primary practice location
101 Airport Road
Iliamna, AK 99606-9800
Mailing address
4201 Tudor Centre Dr
Suite 320
Anchorage, AK 99508-5904
Phone (907) 729-8624
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MDA0153 | 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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 467 | AK | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southcentral Foundation | Past | Accepting new patients |
Organizations & group practices 1
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": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355961600000",
"number": "1952417792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 TUDOR CENTRE DR",
"address_2": "SUITE 320",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995085904",
"telephone_number": "907-729-8624",
"fax_number": "907-729-8607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 AIRPORT ROAD",
"city": "ILIAMNA",
"state": "AK",
"postal_code": "996069800",
"telephone_number": "907-729-8624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILETTE",
"first_name": "SUZANNE",
"middle_name": "MARGARET",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-22",
"last_updated": "2012-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AK",
"license": "467",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MDA0153",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Iliamna, AK
- Cautrese Alexander, LPC, MS, LMHC, CAP
- Ruth Singleton Alvarez, PA-C
- Anne Elizabeth Dailey, PA
- Jacqueline A Jensen
- Sherry D Nelson, PA-C
- Jacquelyn Kay Russell, PA
- Southcentral Foundation (Dental- Nilavena Dental Clinic ( Eaglesoft & Dolph)
- Southcentral Foundation (Dental- Nilavena Dental Clinic)
- Southcentral Foundation (Tribal-Nilavena Regional Health Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.