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BONGO MEDICAL
NPI 1619935558
Internal Medicine - Endocrinology, Diabetes & Metabolism in Anchorage, AK

Active since May 02, 2006CLIA 02D2058715 · Waiver
3260 PROVIDENCE DR, #523, ANCHORAGE, AK 99508(907) 569-1049(907) 563-4564 Get Directions Write a Review

NPPES record last updated: January 3, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Bongo Medical NPPES

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

BONGO MEDICAL (NPI 1619935558) is a healthcare organization registered as an endocrinology, diabetes & metabolism in Anchorage, Alaska and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through May 9, 2027 and lists Leslie A. Glasgow, Ceo, as its authorized official.

NPPES Registry Identity

NPI1619935558
Entity TypeOrganization
Primary Taxonomy207RE0101X
Legal Business NameALASKA KIDNEY & DIABETES ASSOCIATION
Location Address3260 PROVIDENCE DR, #523Anchorage, AK 99508-4608
Mailing Address3260 Providence Dr, #523Anchorage, AK 99508-4608 · (907) 569-1049 · Fax (907) 563-4564
Phone(907) 569-1049
Fax(907) 563-4564
Organization SubpartNo
Authorized OfficialLeslie A. GlasgowCeo · (907) 569-1049
Enumeration DateMay 2, 2006
Last NPPES UpdateJanuary 3, 2013
✔ NPI 1619935558 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

Also ListedInternal Medicine · NephrologyTaxonomy 207RN0300X
3260 PROVIDENCE DR, Anchorage, AK 99508
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Other Names 1

Other NameBongo Medical

Other Identifiers 1

Medicare PINK152825AK

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 02D2058715

Alaska Kidney And Diabetes Associates · Anchorage, AK
Active · expires May 9, 2027
CLIA Number02D2058715
Laboratory TypePhysician Office
Certificate Effective DateMay 10, 2025
Certificate Expiration DateMay 9, 2027
Laboratory DirectorDr. Jeanne R. Bonar
Laboratory Phone(907) 569-1049
Laboratory LocationAlaska Kidney And Diabetes Associates1200 Airport Heights Drive Suite 330, Anchorage, AK 99508
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

PATRICIA MCDONALD ANP
Nurse Practitioner (Primary Care)
3260 PROVIDENCE DR, SUITE 425
ANCHORAGE, AK 99508
Anchorage Municipality (907) 561-7111
DAVID A BRAUNER
Internal Medicine (Cardiovascular Disease)
3260 PROVIDENCE DR, SUITE 321
ANCHORAGE, AK 99508
Anchorage Municipality (907) 261-3655
MS. DEBRA ROSA KRISTICH-MISKILL CNM
Advanced Practice Midwife
3260 PROVIDENCE DR, SUITE 520
ANCHORAGE, AK 99508
Anchorage Municipality (907) 569-8810
HEIDI HURLIMAN ANP
Nurse Practitioner (Women's Health)
3260 PROVIDENCE DR, SUITE 425
ANCHORAGE, AK 99508
Anchorage Municipality (907) 561-7111
TANIA H HALL MD
Obstetrics & Gynecology
3260 PROVIDENCE DR, STE 322
ANCHORAGE, AK 99508
Anchorage Municipality (907) 563-5151
ALASKA WOMENS HEALTH PC
Obstetrics & Gynecology
3260 PROVIDENCE DR, SUITE 322
ANCHORAGE, AK 99508
Anchorage Municipality (907) 563-7228
MRS. AUDREY SUE BURKE MS
Genetic Counselor, MS
3260 PROVIDENCE DR, SUITE 431
ANCHORAGE, AK 99508
Anchorage Municipality (907) 561-4567
ELIZABETH CONKLIN ANP
Nurse Practitioner
3260 PROVIDENCE DR
ANCHORAGE, AK 99508
Anchorage Municipality (907) 677-5829

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 Alaska Kidney & Diabetes Association's NPI number?

The NPI number for Alaska Kidney & Diabetes Association is 1619935558. It was assigned to this organization in the NPPES registry on May 2, 2006. The provider is also known as Bongo Medical.

Where is Alaska Kidney & Diabetes Association located?

Alaska Kidney & Diabetes Association is located at 3260 Providence Dr #523, Anchorage, AK 99508. The listed phone number is (907) 569-1049.

What is Alaska Kidney & Diabetes Association's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Does Alaska Kidney & Diabetes Association hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 02D2058715) is associated with this NPI, valid through May 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Alaska Kidney & Diabetes Association was last updated on January 3, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.