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ANCHORAGE DERMATOLOGY & COSMETICS, LLC
NPI 1609420215
Dermatology in Anchorage, AK

Active since July 31, 2019CLIA 02D2176998 · Microscopy
615 E 82ND AVE STE 204, ANCHORAGE, AK 99518(907) 865-8455(907) 865-8464 Get Directions Write a Review

NPPES record last updated: January 3, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 3, 2022, Mar 18, 2020, Aug 16, 2019 and 1 more (4 updates tracked since 2019).

About Anchorage Dermatology & Cosmetics, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANCHORAGE DERMATOLOGY & COSMETICS, LLC (NPI 1609420215) is a healthcare organization registered as a dermatology in Anchorage, Alaska and active in the NPI registry since July 2019. The organization holds a CLIA Microscopy certificate valid through December 31, 2027, maintains a secondary practice location in Anchorage, and lists Courtney Weathersby Bagayoko, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1609420215
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameANCHORAGE DERMATOLOGY & COSMETICS, LLC
Location Address615 E 82ND AVE STE 204Anchorage, AK 99518-3159
Mailing Address615 E 82nd Ave Ste 204Anchorage, AK 99518-3159 · (907) 865-8455 · Fax (913) 246-4901
Phone(907) 865-8455
Fax(907) 865-8464
Organization SubpartNo
Authorized OfficialCourtney Weathersby BagayokoAuthorized Official · (626) 353-3885
Enumeration DateJuly 31, 2019
Last NPPES UpdateJanuary 3, 20224 updates tracked since enumeration
NPPES CertifiedJanuary 3, 2022
✔ NPI 1609420215 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
615 E 82ND AVE STE 204, Anchorage, AK 99518
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Secondary Practice Location 1

Location 1615 E 82nd Ave Ste 302Anchorage, AK 99518-3159 · Phone (907) 865-8455 · Fax (913) 246-4901

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

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 for Provider-Performed Microscopy Procedures (PPMP) 02D2176998

Anchorage Dermatology & Cosmetics, LLC · Anchorage, AK
Active · expires Dec 31, 2027
CLIA Number02D2176998
Laboratory TypePhysician Office
Certificate Effective DateJanuary 1, 2026
Certificate Expiration DateDecember 31, 2027
Laboratory DirectorDr. Courtney W. Bagayoko
Laboratory Phone(907) 865-8455
Laboratory LocationAnchorage Dermatology & Cosmetics, LLC615 E 82nd Ave, Ste 204, Anchorage, AK 99518
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. COURTNEY WEATHERSBY BAGAYOKO M.D.
Dermatology
615 E 82ND AVE STE 204
ANCHORAGE, AK 99518
Anchorage Municipality (907) 865-8455
LAUREN ASHLEY POULSEN PA-C
Physician Assistant
615 E 82ND AVE STE 204
ANCHORAGE, AK 99518
Anchorage Municipality (907) 865-8455
JODIE BREWER PA-C
Physician Assistant
615 E 82ND AVE STE 204
ANCHORAGE, AK 99518
Anchorage Municipality (907) 865-8455
MR. ROY E HOWARD PA-C
Physician Assistant (Medical)
615 E 82ND AVE STE 204
ANCHORAGE, AK 99518
Anchorage Municipality (907) 865-8455
ALISHA MARIE JENNINGS
Physician Assistant
615 E 82ND AVE STE 204
ANCHORAGE, AK 99518
Anchorage Municipality (907) 865-8455

Frequently 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 Anchorage Dermatology & Cosmetics, LLC's NPI number?

The NPI number for Anchorage Dermatology & Cosmetics, LLC is 1609420215. It was assigned to this organization in the NPPES registry on July 31, 2019.

Where is Anchorage Dermatology & Cosmetics, LLC located?

Anchorage Dermatology & Cosmetics, LLC is located at 615 E 82nd Ave Ste 204, Anchorage, AK 99518. The listed phone number is (907) 865-8455.

What is Anchorage Dermatology & Cosmetics, LLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Anchorage Dermatology & Cosmetics, LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 02D2176998) is associated with this NPI, valid through December 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Anchorage Dermatology & Cosmetics, LLC accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Anchorage Dermatology & Cosmetics, 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 Anchorage Dermatology & Cosmetics, LLC was last updated on January 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.