OLEGARIO CARRILLO (PA-C) – Physician Assistant, NPI 1417946039

OLEGARIO CARRILLO (PA-C) is a healthcare provider. based in Anchorage, Alaska. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 870 (AK). The NPI Number for OLEGARIO CARRILLO (PA-C) is 1417946039

Main info

Male
23 Years Of Experience
Accepts Medicare Assignment
Name
OLEGARIO CARRILLO (PA-C)
NPI
1417946039
Phone
(907) 729-4245
Address
4320 DIPLOMACY DR
Enumeration Date
17 October 2005
Last Update Date
16 April 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9076886031
Graduation Year
2003 (23 years ago)
PAC ID
8527057066
Group Practice PAC ID
5496663627
Professional Enrollment ID
I20100927000270
Address ID
AK995675148CH26341RDXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

551 PHYSICIAN ASSISTANT in AK

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Provider Addresses for OLEGARIO CARRILLO (PA-C)

  • Anchorage Native Primary Care Center, 4320, Diplomacy Drive, Anchorage, Alaska, 99508, United States

    ANCHORAGE, AK 995085925

    Phone: (907) 729-4245

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-09-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100927000270IPhysician AssistantTXTBD
I20140916001095IPhysician AssistantAKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 99508)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5496663627View full group profile

Reviews

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Frequently asked questions

Does OLEGARIO CARRILLO (PA-C) have a public NPI I can cite?
Public records show OLEGARIO CARRILLO (PA-C) under NPI 1417946039.
Should I treat OLEGARIO CARRILLO (PA-C) as an active provider?
Patients and plans typically see OLEGARIO CARRILLO (PA-C) as active in the national extract.
Which specialty label fits OLEGARIO CARRILLO (PA-C)?
NPPES ties OLEGARIO CARRILLO (PA-C) to Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit OLEGARIO CARRILLO (PA-C) in Anchorage, Alaska?
For routing, start with Anchorage, Alaska for OLEGARIO CARRILLO (PA-C), then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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