NPIMap

Individual provider Active NPI

Kristen Marie Iagulli Lee, MD

  • Family Medicine Physician
  • Soldotna, AK
National Provider Identifier
1982894861
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7051 Issued in AK
Practice address
35743 Kenai Spur Hwy Ste a
Soldotna, AK 99669-7161
Phone
(907) 260-4468
Fax
(907) 260-4467
NPI assigned
Jul 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 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 7051 AK Primary

Addresses

Primary practice location

35743 Kenai Spur Hwy Ste a
Soldotna, AK 99669-7161

Mailing address

35743 Kenai Spur Hwy Ste a
Soldotna, AK 99669-7161
Phone (907) 260-4468

Other identifiers 1

IdentifierTypeStateIssuer
MD9804MedicaidAK

Other names 1

  • Kristen M Iagulli Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kristen.lee.1@17172.direct.athenahealth.com Direct

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
I20120119000842 AK Practitioner - Family Practice 8729272703 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Upstream Family Medicine IncGroup PAC ID 7911128434, 4 clinicians

Practice addresses (Care Compare)

35743 Kenai Spur Hwy
Suite a
Soldotna, AK 99669-7161
Phone (907) 260-4468

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7051AKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mat-Su Valley Medical Center LLC CurrentSince Oct 9, 2012 Accepting new patients
Alaska Hospitalist Group LLC CurrentSince Oct 1, 2015 Accepting new patients
Upstream Family Medicine Inc Family Medicine CurrentSince Jan 2, 2014 Accepting new patients
Mat Su Valley Medical Center LLC CurrentSince Oct 9, 2012 Accepting new patients
Providence Health & Services- Washington PastSince Nov 10, 2011 Accepting new patients
Central Peninsula General Hospital Inc. Past Accepting new patients
South Sound Inpatient Physicians PLLC Family Medicine Past Accepting new patients

Locations

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

3200 Providence Dr
Ste D338
Anchorage, AK 99508
Phone (907) 212-3435

4300 B St
Ste 200
Anchorage, AK 99503
Phone (907) 276-1131

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

245 N Binkley St
Ste 103
Soldotna, AK 99669
Phone (907) 260-4468

35743 Kenai Spur Hwy
Ste A
Soldotna, AK 99669
Phone (907) 260-4468

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

950 E Bogard Rd
Wasilla, AK 99654
Phone (907) 352-2880

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17172/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1982894861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35743 KENAI SPUR HWY STE A",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697161",
            "telephone_number": "907-260-4468",
            "fax_number": "907-260-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35743 KENAI SPUR HWY STE A",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697161",
            "telephone_number": "907-260-4468",
            "fax_number": "907-260-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KRISTEN",
        "middle_name": "MARIE IAGULLI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "7051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD9804",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristen.lee.1@17172.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "direct message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "35743 Kenai Spur Hwy Ste A",
            "city": "Soldotna",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996697161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "IAGULLI",
            "middle_name": "M",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Soldotna, AK

Sources for this page

Verify at the official NPI Registry.