Unknown Individual – Interventional Cardiology Physician, NPI 1568635357
Interventional Cardiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
PO BOX 200149
ANCHORAGE, AK 995200149
Phone: (907) 561-3211
Type: Mailing
3043 W DISCOVERY LOOP
WASILLA, AK 996541257
Phone: (814) 572-3477
Type: Mailing
2490 S WOODWORTH LOOP STE 250
PALMER, AK 996457407
Phone: (907) 561-3211
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 23 Open Payments records for all available years, with a total value of $2,862.
Total Amount is formed as General ($2,862) + Research ($0) + Ownership ($0) = $2,862.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: SANOFI-AVENTIS U.S. LLC ($2,240).
Total Amount
$2,862
General + Research + Ownership
Payments
23
Total payment records
General Amount
$2,862
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| SANOFI-AVENTIS U.S. LLC | $2,240 |
| Novartis Pharmaceuticals Corporation | $248 |
| E.R. Squibb & Sons, L.L.C. | $229 |
| Inari Medical, Inc. | $123 |
| Shockwave Medical, Inc | $16 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190624003189 | I | Cardiovascular Disease (Cardiology) | NE | TBD |
| I20190918000358 | I | Interventional Cardiology | AK | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 2,575 | 28 | $0 |
| 93306 | Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | 426 | 404 | $0 |
| J2785 | Injection, regadenoson, 0.1 mg | 408 | 101 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 400 | 283 | $0 |
| 85610 | Blood test, clotting time | 313 | 24 | $0 |
Insurance plans in this area (ZIP 99520)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AK | |
| Nurse Practitioner | WA | |
| - | AK | |
| Cardiovascular Disease (Cardiology), Internal Medicine, Interventional Cardiology | AK | |
| Nurse Practitioner | AK | |
| Cardiac Electrophysiology, Cardiovascular Disease (Cardiology) | AK | |
| Nurse Practitioner | AK | |
| Cardiovascular Disease (Cardiology) | AK | |
| Nurse Practitioner | AK | |
| - | AK |
Reviews
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