Individual provider Active NPI

Chester Joseph Witczak, CRNA

  • Certified Registered Nurse Anesthetist
  • Palmer, AK
National Provider Identifier
1982950978
Registry record updated Jul 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1122 Issued in AK
Practice address
2500 S Woodworth Loop
Palmer, AK 99645-8984
Phone
(717) 968-7149
Fax
(907) 745-0200
NPI assigned
Jul 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1122 AK Primary

Addresses

Primary practice location

2500 S Woodworth Loop
Palmer, AK 99645-8984

Mailing address

610 S Bailey St
Palmer, AK 99645-6330
Phone (717) 968-7149

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130112000014 AK Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496908998 Reassigns benefits to 3 organizations
I20150624000825 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496908998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Denali Anesthesia LLCGroup PAC ID 2567455678, 25 clinicians

Practice addresses (Care Compare)

2801 Debarr Rd
Anchorage, AK 99508-2932
Phone (907) 276-1257

Hospital & facility affiliations

  • Alaska Regional Hospital Hospital, Anchorage, AK, CCN 020017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
405AKMDPhysical Therapist
1122AKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Denali Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2021 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Aug 8, 2019 Accepting new patients
City of Valdez CurrentSince May 29, 2023 Accepting new patients
Anesthesia Care Associates, PC CurrentSince Jul 26, 2018 Accepting new patients

Locations

2801 Debarr Rd
Anchorage, AK 99508
Phone (907) 264-1222

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

2500 S Woodworth Loop
Palmer, AK 99645
Phone (907) 861-6000

911 Meals Ave
Valdez, AK 99686
Phone (907) 835-2249

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

Interoperability endpoints

  • Direct secure messaging: cwitczak@direct.anthc.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343347200000",
    "number": "1982950978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S BAILEY ST",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456330",
            "telephone_number": "717-968-7149",
            "fax_number": "907-745-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S WOODWORTH LOOP",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996458984",
            "telephone_number": "717-968-7149",
            "fax_number": "907-745-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITCZAK",
        "first_name": "CHESTER",
        "middle_name": "JOSEPH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-27",
        "last_updated": "2012-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AK",
            "license": "1122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; 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.

Verify at the official NPI Registry.