A4 Specialty Medical Group Llc - Medicare Primary Care in Anchorage, AK

A4 Specialty Medical Group Llc is a medicare enrolled primary clinic (Clinic/center - Multi-specialty) in Anchorage, Alaska. The current practice location for A4 Specialty Medical Group Llc is 510 W Tudor Rd Ste 1, Anchorage, Alaska. For appointments, you can reach them via phone at (907) 223-7347. The mailing address for A4 Specialty Medical Group Llc is 510 W Tudor Rd Ste 1, Anchorage, Alaska and phone number is (907) 223-7347.

A4 Specialty Medical Group Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1659010361. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (907) 223-7347.

Contact Information

A4 Specialty Medical Group Llc
510 W Tudor Rd Ste 1
Anchorage
AK 99503-6649
(907) 223-7347
Not Available

Primary Care Clinic Profile

Full NameA4 Specialty Medical Group Llc
SpecialityClinic/Center
Location510 W Tudor Rd Ste 1, Anchorage, Alaska
Authorized Official Name and PositionLisa Bruce (CHIEF OPERATING OFFICER)
Authorized Official Contact9072237347
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
A4 Specialty Medical Group Llc
510 W Tudor Rd Ste 1
Anchorage
AK 99503-6649

Ph: (907) 223-7347
A4 Specialty Medical Group Llc
510 W Tudor Rd Ste 1
Anchorage
AK 99503-6649

Ph: (907) 223-7347

NPI Details:

NPI Number1659010361
Provider Enumeration Date06/01/2022
Last Update Date06/01/2022

Medicare PECOS Information:

Medicare PECOS PAC ID7315313558
Medicare Enrollment IDO20221013000870

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Medical Identifiers

Medical identifiers for A4 Specialty Medical Group Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1659010361NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM1300XClinic/center - Multi-specialty (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. A4 Specialty Medical Group Llc acts as a billing entity for following providers:
Provider NameJeffrey G Demain
Provider TypePractitioner - Allergy/immunology
Provider IdentifiersNPI Number: 1548201395
PECOS PAC ID: 7810989399
Enrollment ID: I20040706000728

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Provider NameMelissa Van Fossen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1235837865
PECOS PAC ID: 6204291792
Enrollment ID: I20230505002290

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Provider NameCielito Marie Bundang Bowen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1437921095
PECOS PAC ID: 9638528060
Enrollment ID: I20231212000051

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