EAGLE RIVER DERMATOLOGY INC
NPI 1750880654
Dermatology in Eagle River, AK
About Eagle River Dermatology Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EAGLE RIVER DERMATOLOGY INC (NPI 1750880654) is a healthcare organization registered as a dermatology in Eagle River, Alaska and active in the NPI registry since February 2018. The organization lists Lindsay Jay Proctor, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
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)
Eagle River Dermatology Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Eagle River Dermatology Inc, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Eagle River Dermatology Inc's NPI number?
The NPI number for Eagle River Dermatology Inc is 1750880654. It was assigned to this organization in the NPPES registry on February 6, 2018.
Where is Eagle River Dermatology Inc located?
Eagle River Dermatology Inc is located at 16839 Park Place St, Eagle River, AK 99577. The listed phone number is (907) 694-3303.
What is Eagle River Dermatology Inc's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Eagle River Dermatology Inc enrolled in Medicare?
Yes. Eagle River Dermatology Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Eagle River Dermatology Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Eagle River Dermatology Inc. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Eagle River Dermatology Inc accept?
Health plans from Moda Health Plan, Inc. and Premera Blue Cross Blue Shield of Alaska list Eagle River Dermatology Inc 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 Eagle River Dermatology Inc was last updated on February 6, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.