| Mat-su Regional Urgent Care | |
|
950 E Bogard Rd Ste 103 Wasilla AK 99654-7184 | |
| (907) 352-2880 | |
| (907) 352-2885 |
| Full Name | Mat-su Regional Urgent Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 950 E Bogard Rd Ste 103, Wasilla, Alaska |
| Authorized Official Name and Position | Jennifer L Jackson (SR DIRECTOR PROVIDER ENROLLMENT CVS) |
| Authorized Official Contact | 6154653334 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mat-su Regional Urgent Care Po Box 689022 Franklin TN 37068-9022 Ph: (615) 465-7042 | Mat-su Regional Urgent Care 950 E Bogard Rd Ste 103 Wasilla AK 99654-7184 Ph: (907) 352-2880 |
| NPI Number | 1912950148 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 06/18/2023 |
| Medicare PECOS PAC ID | 5698686475 |
|---|---|
| Medicare Enrollment ID | O20040123000583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912950148 | NPI | - | NPPES |
| 1020601 | Medicaid | AK |
| Provider Name | Wade S Erickson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245278183 PECOS PAC ID: 1658269626 Enrollment ID: I20040310000457 |
| Provider Name | John C Boston |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982666137 PECOS PAC ID: 8123017761 Enrollment ID: I20040510000659 |
| Provider Name | Paul D Forman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871606004 PECOS PAC ID: 5294729877 Enrollment ID: I20040527000333 |
| Provider Name | Shelis R Jorgensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164481107 PECOS PAC ID: 6800866807 Enrollment ID: I20040728000239 |
| Provider Name | Linda A Ireland |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588689368 PECOS PAC ID: 3779553607 Enrollment ID: I20040728001248 |
| Provider Name | Lisa N Gray |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912922329 PECOS PAC ID: 8527039320 Enrollment ID: I20040804001389 |
| Provider Name | Christopher T Patricoski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669518957 PECOS PAC ID: 5193765113 Enrollment ID: I20050510000360 |
| Provider Name | Stanley P Watkins |
|---|---|
| Provider Type | Practitioner - Peripheral Vascular Disease |
| Provider Identifiers | NPI Number: 1548294945 PECOS PAC ID: 3971537762 Enrollment ID: I20050921000582 |
| Provider Name | Adam C Mason |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1902824287 PECOS PAC ID: 6608891833 Enrollment ID: I20051006000995 |
| Provider Name | Mark A Selland |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669490900 PECOS PAC ID: 7113826926 Enrollment ID: I20060725000033 |
| Provider Name | Richard A Anschuetz |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1386669174 PECOS PAC ID: 3870492689 Enrollment ID: I20060725000041 |
| Provider Name | Steven J Compton |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1548285901 PECOS PAC ID: 3678472487 Enrollment ID: I20060725000061 |
| Provider Name | William P Mayer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437177714 PECOS PAC ID: 5597664300 Enrollment ID: I20060725000148 |
| Provider Name | David W Sonneborn |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1316965692 PECOS PAC ID: 0244139053 Enrollment ID: I20060725000165 |
| Provider Name | Mario Binder |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265457022 PECOS PAC ID: 4789697475 Enrollment ID: I20060725000260 |
| Provider Name | Alan E Skolnick |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548287121 PECOS PAC ID: 5092796524 Enrollment ID: I20060725000269 |
| Provider Name | Seth L Krauss |
|---|---|
| Provider Type | Practitioner - Peripheral Vascular Disease |
| Provider Identifiers | NPI Number: 1801814173 PECOS PAC ID: 9335048149 Enrollment ID: I20060726000006 |
| Provider Name | Thomas K Kramer |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1083635742 PECOS PAC ID: 6103725916 Enrollment ID: I20060726000274 |
| Provider Name | Christopher Kent Dyke |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891704409 PECOS PAC ID: 4789645490 Enrollment ID: I20060921000645 |
| Provider Name | Brian T Scully |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1841209368 PECOS PAC ID: 7416952635 Enrollment ID: I20060921000646 |
| Provider Name | Ankie Marie Amos |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1912911017 PECOS PAC ID: 6800893918 Enrollment ID: I20061219000183 |
| Provider Name | Michael R Alexander |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124041645 PECOS PAC ID: 9032017108 Enrollment ID: I20070111000264 |
| Provider Name | Shawn A Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295878429 PECOS PAC ID: 4183725294 Enrollment ID: I20070719000340 |
| Provider Name | Katherine N Naylor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013938729 PECOS PAC ID: 6305840356 Enrollment ID: I20071116000390 |
| Provider Name | Pravina Sheth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700810561 PECOS PAC ID: 5799848750 Enrollment ID: I20090821000205 |
| Provider Name | Kristen Marie Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982894861 PECOS PAC ID: 8729272703 Enrollment ID: I20120119000842 |
| Provider Name | Jeffrey E Godwin |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1184604720 PECOS PAC ID: 7214831718 Enrollment ID: I20120801000774 |
| Provider Name | Christopher Thomas |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710179494 PECOS PAC ID: 9638325962 Enrollment ID: I20120801000956 |
| Provider Name | Larry S Owen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396859666 PECOS PAC ID: 1355399858 Enrollment ID: I20130212000295 |
| Provider Name | Yiming Wu |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1225248669 PECOS PAC ID: 5395984173 Enrollment ID: I20130627000309 |
| Provider Name | Mark Hansen |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1851566947 PECOS PAC ID: 7315091212 Enrollment ID: I20150506001407 |
| Provider Name | Amber L Tandeske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558529008 PECOS PAC ID: 3274852504 Enrollment ID: I20150507001009 |
| Provider Name | Tokunbo James Matthews |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205994852 PECOS PAC ID: 7012167786 Enrollment ID: I20150722006544 |
| Provider Name | Alyse Poll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598135089 PECOS PAC ID: 8921309287 Enrollment ID: I20161013001957 |
| Provider Name | Robert Emmett O'connor Iii |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1710103270 PECOS PAC ID: 8123126984 Enrollment ID: I20161123000894 |
| Provider Name | Thomas E O'mara |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1588649412 PECOS PAC ID: 9133021215 Enrollment ID: I20170313001262 |
| Provider Name | Michael Andrew Cole |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1013983501 PECOS PAC ID: 3274766613 Enrollment ID: I20170329001920 |
| Provider Name | Patricia Beth Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346776150 PECOS PAC ID: 7719257351 Enrollment ID: I20170714000998 |
| Provider Name | Rachel Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588990915 PECOS PAC ID: 4688935380 Enrollment ID: I20180220002363 |
| Provider Name | Michael A Dibartolo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316999808 PECOS PAC ID: 9931353109 Enrollment ID: I20180613000473 |
| Provider Name | Violeta Diana Yeager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518488204 PECOS PAC ID: 5395002414 Enrollment ID: I20190103002953 |
| Provider Name | Karen Ni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770781007 PECOS PAC ID: 0648439711 Enrollment ID: I20190204002070 |
| Provider Name | Mariam I Garuba |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275748261 PECOS PAC ID: 1759536576 Enrollment ID: I20190221001099 |
| Provider Name | Bethany N Neubarth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124511043 PECOS PAC ID: 5799116463 Enrollment ID: I20200513000607 |
| Provider Name | Zachary M Buck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871023135 PECOS PAC ID: 3577832302 Enrollment ID: I20200625003258 |
| Provider Name | Trisha A. Kernodle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891344297 PECOS PAC ID: 2163845306 Enrollment ID: I20200707002790 |
| Provider Name | Austin Bills |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336669092 PECOS PAC ID: 3274802012 Enrollment ID: I20201022000492 |
| Provider Name | Katrina L San Juan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770067985 PECOS PAC ID: 0648515502 Enrollment ID: I20210215000897 |
| Provider Name | Tricia Hosyrami |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548672306 PECOS PAC ID: 7911123377 Enrollment ID: I20210816004129 |
| Provider Name | Marcus Thiemann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750876629 PECOS PAC ID: 5991054439 Enrollment ID: I20210903002677 |
| Provider Name | Jessica Lynn Bray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104590751 PECOS PAC ID: 4688072234 Enrollment ID: I20211012001511 |
| Provider Name | Jennifer Gail Vinette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053049791 PECOS PAC ID: 2264804673 Enrollment ID: I20230213002016 |
| Provider Name | Marti Marie Anliker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235843863 PECOS PAC ID: 2961876636 Enrollment ID: I20230320001819 |
| Provider Name | Loyal Farley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659930006 PECOS PAC ID: 3375901002 Enrollment ID: I20230628000029 |
| Provider Name | Tabitha Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467132340 PECOS PAC ID: 4385099019 Enrollment ID: I20231016001413 |
| Provider Name | Ryah Mckinley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063945871 PECOS PAC ID: 2860749421 Enrollment ID: I20231030001696 |
| Provider Name | Martin Cook |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477176543 PECOS PAC ID: 0749605970 Enrollment ID: I20231121002554 |
| Provider Name | Jamie Alexander |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700382363 PECOS PAC ID: 6709237035 Enrollment ID: I20240110004166 |
| Provider Name | Mikaela Maree Hull |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437901725 PECOS PAC ID: 0547600546 Enrollment ID: I20240424001455 |
Wild Iris Family Medicine And Maternity Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 851 E Westpoint Dr, Suite 207, Wasilla, AK 99654 Phone: 907-373-9463 | |
Family Medicine Of Alaska Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1261 S Seward Meridian Pkwy, Suite A, Wasilla, AK 99654 Phone: 907-376-1276 Fax: 907-373-0755 | |
Integrated Care, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 540 E Hjellen Drive, Wasilla, AK 99654 Phone: 907-696-1654 Fax: 907-696-3654 | |
Sunshine Community Health Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10015 Redington Rd, Wasilla, AK 99687 Phone: 907-733-2273 | |
Odland Family Practice Clinic, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 950 E Bogard Rd, Suite 234, Wasilla, AK 99654 Phone: 907-355-0850 Fax: 907-373-0117 | |
David L. Barnes, D.o. Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3719 E Meridian Loop Ste A, Wasilla, AK 99654 Phone: 907-376-2868 Fax: 907-376-2811 | |
Alaska Heart Clinic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 950 Bogard Rd, Suite 207, Wasilla, AK 99654 Phone: 907-357-9444 |