ALPINE MEDICAL GROUP LLC
NPI 1114681608
Nurse Practitioner - Family in Fairbanks, AK
About Alpine Medical Group Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ALPINE MEDICAL GROUP LLC (NPI 1114681608) is a healthcare organization registered as a family in Fairbanks, Alaska and active in the NPI registry since October 2021. The organization holds a CLIA Waiver certificate valid through November 10, 2026, maintains a secondary practice location in Fairbanks, and lists Haley Evens, Authorized Official, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 5
Secondary Practice Location 1
Group Practice 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Alpine Medical Group Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
9Medicare enrollment records show 9 clinicians reassign Medicare billing to Alpine Medical Group LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 8 within 10 miles. They are listed nearest first.
Clinicians, nearest first (9)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 02D2271966
Alpine Medical Group · Fairbanks, AKFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Alpine Medical Group LLC's NPI number?
The NPI number for Alpine Medical Group LLC is 1114681608. It was assigned to this organization in the NPPES registry on October 29, 2021.
Where is Alpine Medical Group LLC located?
Alpine Medical Group LLC is located at 605 Chief Thomas Dr, Fairbanks, AK 99709. The listed phone number is (907) 455-4555.
What is Alpine Medical Group LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Alpine Medical Group LLC enrolled in Medicare?
Yes. Alpine Medical Group LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Alpine Medical Group LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 3 Medicare specialties reassign their Medicare billing to Alpine Medical Group LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (6), Family Practice (2) and Osteopathic Manipulative Medicine (1). Of these, 1 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Alpine Medical Group LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 02D2271966) is associated with this NPI, valid through November 10, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Alpine Medical Group LLC accept?
Health plans from Moda Health Plan, Inc. and Premera Blue Cross Blue Shield of Alaska list Alpine Medical Group LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Alpine Medical Group LLC was last updated on September 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Alpine Medical Group Llc · NPI 1114681608
Family organization in Fairbanks, Alaska. Organization record, active in the CMS NPPES registry since October 29, 2021.
## Identity
- **NPI:** 1114681608 (Entity type: Organization)
- **Enumerated:** October 29, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Haley Evens, AUTHORIZED OFFICIAL
## Practice location
- **Address:** 605 CHIEF THOMAS DR, Fairbanks, AK 99709-4848
- **Phone:** (907) 455-4555 · **Fax:** (833) 941-2349
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 9 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (6), Family Practice (2), Osteopathic Manipulative Medicine (1); 1 practice at this address and 8 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 4, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1114681608) · Data from the CMS NPPES public registry.