PROVIDENCE HEALTH & SERVICES WASHINGTON
NPI 1952430902
Emergency Medicine - Emergency Medical Services in Kodiak, AK
About Providence Health & Services Washington NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROVIDENCE HEALTH & SERVICES WASHINGTON (NPI 1952430902), doing business as Providence Kodiak Island Medical Center, is a healthcare organization registered as an emergency medical services in Kodiak, Alaska and active in the NPI registry since March 2007. The organization lists Donald Wayne Anderson, Assistant Secretary Of Enrollments, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Other Identifiers 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)
Providence Health & Services Washington is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
73Medicare enrollment records show 73 clinicians reassign Medicare billing to Providence Health & Services Washington, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 9 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 16
Nearest to this location (20)
See all 73Source: 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 Providence Health & Services Washington's NPI number?
The NPI number for Providence Health & Services Washington is 1952430902. It was assigned to this organization in the NPPES registry on March 5, 2007. The provider is doing business as Providence Kodiak Island Medical Center.
Where is Providence Health & Services Washington located?
Providence Health & Services Washington is located at 1915 E Rezanof Dr, Kodiak, AK 99615. The listed phone number is (907) 486-3281.
What is Providence Health & Services Washington's specialty?
The primary specialty registered for this NPI is Emergency Medicine, specializing in Emergency Medical Services, with taxonomy code 207PE0004X.
Is Providence Health & Services Washington enrolled in Medicare?
Yes. Providence Health & Services Washington is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Providence Health & Services Washington?
According to the CMS Revalidation Reassignment List (October 2026 release), 73 clinicians in 16 Medicare specialties reassign their Medicare billing to Providence Health & Services Washington. 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 Cardiovascular Disease (Cardiology) (14), Family Practice (14) and Certified Registered Nurse Anesthetist (CRNA) (8). Of these, 4 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Providence Health & Services Washington accept?
Health plans from Premera Blue Cross Blue Shield of Alaska list Providence Health & Services Washington 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 Providence Health & Services Washington was last updated on May 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.
# Providence Health & Services Washington · NPI 1952430902
Emergency Medical Services organization in Kodiak, Alaska. Organization record, active in the CMS NPPES registry since March 5, 2007.
## Identity
- **NPI:** 1952430902 (Entity type: Organization)
- **Enumerated:** March 5, 2007
- **Primary specialty:** Emergency Medicine - Emergency Medical Services · taxonomy 207PE0004X
- **Also known as:** Providence Kodiak Island Medical Center (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Donald Anderson, ASSISTANT SECRETARY OF ENROLLMENTS
## Practice location
- **Address:** 1915 E REZANOF DR, Kodiak, AK 99615-6602
- **Phone:** (907) 486-3281
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 73 clinicians in 16 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Cardiovascular Disease (Cardiology) (14), Family Practice (14), Certified Registered Nurse Anesthetist (CRNA) (8); 4 practice at this address and 9 within 10 miles; [full list](https://npiprofile.com/npi/1952430902/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 13, 2025
- **Other identifiers:** Medicaid MDG191 (AK)
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Source: [NPI Profile](https://npiprofile.com/npi/1952430902) · Data from the CMS NPPES public registry.