DR. MARY GANNETT (M.D.) – Pediatrics Physician, NPI 1750356747

DR. MARY GANNETT (M.D.) is a healthcare provider. based in Fairbanks, Alaska. specializing in PEDIATRIC MEDICINE. They hold the professional credentials M.D.. They hold a License No. 4081 (AK). The NPI Number for DR. MARY GANNETT (M.D.) is 1750356747

Main info

Female
34 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARY GANNETT (M.D.)
NPI
1750356747
Phone
(907) 459-3500
Address
1001 NOBLE ST
Enumeration Date
22 February 2006
Last Update Date
7 March 2023

Doctor Profile

Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Secondary Phone
9074593500
Graduation Year
1992 (34 years ago)
PAC ID
9335151893
Group Practice PAC ID
5698056901
Professional Enrollment ID
I20060627000096
Address ID
AK997014948FA1001XSTXX300
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

44 PEDIATRIC MEDICINE in AK

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Provider Addresses for DR. MARY GANNETT (M.D.)

  • 1001, Noble Street, South Fairbanks, Fairbanks, Fairbanks North Star, Alaska, 99701, United States

    FAIRBANKS, AK 997014922

    Phone: (907) 459-3500

    Fax: (907) 459-3554

    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: 2006-06-27

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20060627000096IPediatric MedicineAKTBD

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 99701)

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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: 5698056901View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)LA
Certified Registered Nurse Anesthetist (Crna)AK
A N E S T H E S I O L O G YMD
P S Y C H I A T R YWA
H O S P I T A L I S TCA
Emergency MedicineAK
U R O L O G YAK
Family PracticeAK
-AK
P S Y C H I A T R YHI

Reviews

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Frequently asked questions

Can I use this page to confirm DR. MARY GANNETT (M.D.)'s NPI?
Yes. DR. MARY GANNETT (M.D.) is listed with NPI 1750356747 in the public NPI dataset.
Is DR. MARY GANNETT (M.D.) listed as active for patients and plans?
The listing shows DR. MARY GANNETT (M.D.) as active in the NPI system.
What taxonomy line describes DR. MARY GANNETT (M.D.)?
For research purposes, treat DR. MARY GANNETT (M.D.) as Pediatrics Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does DR. MARY GANNETT (M.D.) list a practice location?
Patients near Fairbanks, Alaska may find DR. MARY GANNETT (M.D.) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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