DR. JEFFREY BRENT ROATEN (NPI# 1558546788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558546788 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY BRENT ROATEN |
| Credential | MD PHD |
| Practice Address |
4100 Lake Otis Pkwy Ste 312 Anchorage AK 99508-5231 |
| Practice Telephone | 9079297337 |
| Mailing Telephone | 9079297337 |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2019-09-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 6550 | AK | Allopathic & Osteopathic Physicians |
| N | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
43121 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MD1272 | 05 |
| Street Address |
4100 LAKE OTIS PKWY STE 312 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-5231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821135427 | Matt A Heilala | Podiatrist | 4100 Lake Otis Pkwy Ste 312, Anchorage, AK 99508-5231 | 2007-01-31 |
| 1003459298 | Alaska Bleeding Disorder Clinics | Internal Medicine | 4100 Lake Otis Pkwy Ste 312, Anchorage, AK 99508-5231 | 2019-10-21 |
| 1982881421 | Shannon Rochelle Norman | Pediatrics | 4100 Lake Otis Pkwy Ste 312, Anchorage, AK 99508-5231 | 2008-01-28 |
| 1255478863 | Jennifer Jansma | Podiatrist | 4100 Lake Otis Pkwy Ste 312, Anchorage, AK 99508-5231 | 2007-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316407992 | Center for Vein Restoration Ak LLC | Surgery | 2550 Denali St Ste 1307, Anchorage, AK 99503-2752 | 2019-03-21 |
| 1184954265 | Catherine Anne Morrison | Surgery | 3220 Providence Dr Ste 3080, Anchorage, AK 99508-4679 | 2010-01-12 |
| 1396843462 | James E Omalley Md PC | Surgery | 1601 Hidden Ln, Anchorage, AK 99501 | 2006-09-20 |
| 1780782847 | James E O'malley | Surgery | 1615 Hidden Ln, Anchorage, AK 99501-4917 | 2006-09-20 |
| 1831136456 | Michael A Todd | Surgery | 4100 Lake Otis Pkwy Ste 302, Anchorage, AK 99508-5230 | 2006-06-01 |
| 1548267032 | Kerrie Rochelle Bossard | Surgery | 2751 Debarr Rd, Suite 280, Anchorage, AK 99508-2952 | 2005-06-30 |
| 1598230088 | Alaska Surgical Group, LLC | Surgery | 3851 Piper St Ste U230, Anchorage, AK 99508-6901 | 2018-10-10 |
| 1174076822 | Anchorage Bariatrics, LLC | Surgery | 3909 Arctic Blvd, Suite 101, Anchorage, AK 99503-5770 | 2016-07-29 |
| 1194181586 | Alaska Surgical Arts PC | Surgery | 2741 Debarr Rd, Suite C-415, Anchorage, AK 99508-2961 | 2016-01-14 |
| 1629433701 | Alaska Breast Care Specialists PC | Surgery | 2741 Debarr Rd, Suite 402, Anchorage, AK 99508-2961 | 2015-12-16 |
| Find all providers in ANCHORAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.