Individual provider Active NPI

Alyssa Gardner, MD

  • Family Medicine Physician
  • Anchorage, AK
National Provider Identifier
1952920704
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
223917 Issued in AK
Practice address
1201 E 36TH Ave
Anchorage, AK 99508-4372
Phone
(907) 562-9229
Fax
(907) 562-1603
NPI assigned
Apr 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 223917 AK Primary

Addresses

Primary practice location

1201 E 36TH Ave
Anchorage, AK 99508-4372

Mailing address

PO Box 4105
Portland, OR 97208-4105
Phone (866) 907-1068

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240920000417 AK Practitioner - Family Practice 3678014495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services- WashingtonGroup PAC ID 1557408176, 219 clinicians

Practice addresses (Care Compare)

1201 E 36TH Ave
Anchorage, AK 99508-4372
Phone (907) 562-9229

Hospital & facility affiliations

  • Providence at Home With Compassus HH Anchorage Home health agency, Anchorage, AK, CCN 027001
  • Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223917AKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Sep 10, 2024 Accepting new patients
Providence Health & Services Washington Past Accepting new patients

Locations

1201 E 36th Ave
Anchorage, AK 99508
Phone (907) 562-9229

920 Compassion Cir
Anchorage, AK 99504
Phone (907) 212-9200

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1586649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1952920704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084105",
            "telephone_number": "866-907-1068",
            "fax_number": "425-917-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E 36TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084372",
            "telephone_number": "907-562-9229",
            "fax_number": "907-562-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "ALYSSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-12",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "223917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.