Martin David Bomalaski, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

5610 Issued in AK

Practice address

3841 Piper St
Suite T300
Anchorage, AK 99508-4624

Phone

(907) 563-3103

Fax

(907) 561-1862

NPI assigned

Jan 12, 2006

Last updated

Dec 20, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• The University of Texas Health Science Center at San Antonio

  dba UT Health San Antonio Multispecialty & Research Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD (past)

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1982683504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 PIPER ST",
            "address_2": "SUITE T300",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084624",
            "telephone_number": "907-563-3103",
            "fax_number": "907-561-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3841 PIPER ST",
            "address_2": "SUITE T300",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084624",
            "telephone_number": "907-563-3103",
            "fax_number": "907-561-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMALASKI",
        "first_name": "MARTIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AK",
            "license": "5610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD12491",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Bolling
• Bryan Buo Bolo
• Patrick Kevin Bolte, PHARM.D.
• Yong Sun Bolton, MASSAGE THERAPIST
• Sue Boma
• Susan Bomalaski, PH.D.
• Jeanne R Bonar, MD
• Kyle Andrew Bonar, M.D.
• Heather Bond
• Jesse Steffan Bond, M.D.

• Urology Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Urology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.