NPIMap

Individual provider Active NPI

Dale Robert Walaszek, P.A.

  • Physician Assistant
  • Soldotna, AK
National Provider Identifier
1962512293
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PADA1183 Issued in AK
Practice address
245 N Binkley St
Soldotna, AK 99669-7500
Phone
(907) 714-4521
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2005-0017 NM
Physician Assistant 363A00000X PADA1183 AK Primary

Addresses

Primary practice location

245 N Binkley St
Soldotna, AK 99669-7500

Mailing address

250 Hospital PL
Soldotna, AK 99669-6999
Phone (907) 714-4502

Other practice location 1

354 Tyee St
Soldotna, AK 99669-7657
Phone (907) 714-5870

Other practice location 2

47480 Kristina Way
Kenai, AK 99611-5902
Phone (907) 714-4521

Other practice location 3

362 Tyee St
Soldotna, AK 99669-7631
Phone (907) 714-4521

Other identifiers 1

IdentifierTypeStateIssuer
1615861MedicaidAK

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dwalaszek635747@ak.providencedirect.org
Direct Messaging Address dwalaszek635754@ak.providencedirect.org

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
I20141107002135 AK Practitioner - Physician Assistant 2769499409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Peninsula General Hospital IncGroup PAC ID 4587552575, 119 clinicians

Practice addresses (Care Compare)

240 Hospital PL
Soldotna, AK 99669-7559
Phone (907) 714-4090

245 N Binkley St
Soldotna, AK 99669-7500
Phone (907) 714-4521

250 Hospital PL
Soldotna, AK 99669-7559
Phone (907) 714-4515

Hospital & facility affiliations

  • Central Peninsula General Hospital Hospital, Soldotna, AK, CCN 020024

Merit-based Incentive Payment System (MIPS)

Final score
75.44 of 100Reported as group
Quality
62.56
Promoting interoperability
81
Improvement activities
40
Cost
67.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Bachelor of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
1183AKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Peninsula General Hospital Inc Physician Assistant CurrentSince Jul 5, 2016 Accepting new patients
North Star Medical Imaging PLLC Current Accepting new patients
Central Peninsula General Hospital, Inc CurrentSince Jul 5, 2016 Accepting new patients
Central Peninsula General Hospital Inc Past Accepting new patients
Central Peninsula General Hospital, Inc Past Accepting new patients
Central Peninsula General Hospital, Inc Past Accepting new patients
Central Peninsula General Hospital, Inc PastSince Dec 13, 2020 Accepting new patients
Central Peninsula General Hospital, Inc PastSince Oct 25, 2020 Accepting new patients

Locations

250 Hospital Pl
Soldotna, AK 99669
Phone (907) 714-4404

245 N Binkley St
Soldotna, AK 99669
Phone (907) 714-4111

245 N Binkley St
Ste 202
Soldotna, AK 99669
Phone (907) 260-3353

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1962512293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 HOSPITAL PL",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996696999",
            "telephone_number": "907-714-4502",
            "fax_number": "907-714-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N BINKLEY ST",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697500",
            "telephone_number": "907-714-4521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "354 Tyee St",
            "address_purpose": "LOCATION",
            "city": "Soldotna",
            "state": "AK",
            "postal_code": "996697657",
            "country_code": "US",
            "telephone_number": "907-714-5870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "47480 Kristina Way",
            "address_purpose": "LOCATION",
            "city": "Kenai",
            "state": "AK",
            "postal_code": "996115902",
            "country_code": "US",
            "telephone_number": "907-714-4521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "362 Tyee St",
            "address_purpose": "LOCATION",
            "city": "Soldotna",
            "state": "AK",
            "postal_code": "996697631",
            "country_code": "US",
            "telephone_number": "907-714-4521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALASZEK",
        "first_name": "DALE",
        "middle_name": "ROBERT",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2005-0017",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "PADA1183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1615861",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwalaszek635747@ak.providencedirect.org",
            "affiliation": "N",
            "endpointDescription": "provider direct messaging address",
            "address_1": "245 N Binkley St",
            "city": "Soldotna",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996697500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwalaszek635754@ak.providencedirect.org",
            "affiliation": "N",
            "endpointDescription": "Provider direct messaging address",
            "address_1": "265 N Binkley St Ste 202",
            "city": "Soldotna",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996697523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

Verify at the official NPI Registry.