Active NPI
Aa Pain Clinic, Inc.
- Pain Medicine Physician
- Anchorage, AK
National Provider Identifier
1972596633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine Physician
- Legal business name
- AA PAIN CLINIC, INC.
- Practice address
- 4100 Lake Otis Pkwy
Suite 216
Anchorage, AK 99508-5222 - Phone
- (907) 563-2873
- Fax
- (907) 563-5852
- NPI assigned
- Aug 29, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Leon Chandler, MD
- Title
- President
- Phone
- (907) 563-2873
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine Physician | 208VP0000X | Primary |
Addresses
Primary practice location
4100 Lake Otis Pkwy
Suite 216
Anchorage, AK 99508-5222
Mailing address
PO Box 202113
Anchorage, AK 99520-2113
Phone (907) 929-8704
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MDG444 | Medicaid | AK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040216000359 | AK | Part B Supplier - Clinic/Group Practice | 7911892443 |
Receives reassigned benefits from 12 practitioners Practice locations: Anchorage, AK; Kenai, AK; Fairbanks, AK |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 02D1030244 | Aa Spine and Pain Clinic | Accreditation | Aug 23, 2026 |
National Provider Directory
National Provider DirectoryLocations
4100 Lake Otis Pkwy
Ste 216
Anchorage, AK 99508
Phone (907) 563-2873
3202 International St
Ste 200
Fairbanks, AK 99701
Phone (907) 328-0582
267 E Park Ave
Ste 3
Wasilla, AK 99654
Interoperability endpoints
- https://api.platform.athenahealth.com/14826/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 13
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Anchorage, AK
- NPI 1699746941
AK
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125273600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1972596633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 202113",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995202113",
"telephone_number": "907-929-8704",
"fax_number": "907-929-8744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 LAKE OTIS PKWY",
"address_2": "SUITE 216",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995085222",
"telephone_number": "907-563-2873",
"fax_number": "907-563-5852"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AA PAIN CLINIC, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-29",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "CHANDLER",
"authorized_official_first_name": "LEON",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "907-563-2873",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208VP0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pain Medicine, Pain Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MDG444",
"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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.