Individual provider Active NPI

Jesika Harrell, PA-C

  • Medical Physician Assistant
  • Anchorage, AK
National Provider Identifier
1972980639
Registry record updated May 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PADA1252 Issued in AK
Practice address
500 East Benson Blvd
Suite 103
Anchorage, AK 99623
Phone
(907) 250-2511
NPI assigned
May 1, 2015
Last updated
May 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PADA1252 AK Primary

Addresses

Primary practice location

500 East Benson Blvd
Suite 103
Anchorage, AK 99623

Mailing address

500 East Benson Blvd, Suite 103
Anchorage, AK 99623-7255
Phone (907) 250-2511

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150928002700 AK Practitioner - Physician Assistant 8820306632 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PADA1252AKMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Group of Alaska CurrentSince Aug 1, 2015 Accepting new patients
Health Quest Therapy, Inc. CurrentSince Feb 8, 2017 Accepting new patients

Locations

500 E Benson Blvd
Ste 103
Anchorage, AK 99503
Phone (907) 250-9441

8800 Glacier Hwy
Ste 220
Juneau, AK 99801
Phone (907) 523-5003

3066 E Meridian Park Loop
Ste 1
Wasilla, AK 99654
Phone (907) 707-1671

3190 E Meridian Park Loop
Ste 207
Wasilla, AK 99654
Phone (907) 357-7710

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DACAAA

Organizations & group practices 4

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": "1430438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1972980639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 EAST BENSON BLVD, SUITE 103",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "996237255",
            "telephone_number": "907-250-2511",
            "fax_number": "907-250-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 EAST BENSON BLVD",
            "address_2": "SUITE 103",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99623",
            "telephone_number": "907-250-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "JESIKA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-01",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "PADA1252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.