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DR. JEFFREY BRENT ROATEN MD PHD NPI 1558546788


NPI Information

NPI: 1558546788
Provider Name: DR. JEFFREY BRENT ROATEN, MD PHD
Classification: Surgery - 208600000X
Entity Type: Individual
Organization: ALASKA PEDIATRIC SURGERY LLC

PECOS Registration: Yes

Address:
4100 LAKE OTIS PKWY STE 312
ANCHORAGE, AK
ZIP 99508
Phone: (907) 929-7337
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DR. Jeffrey Brent Roaten, MD PHD is a surgery in Anchorage, AK with 23 years of experience. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. DR. Jeffrey Brent Roaten, MD PHD NPI is 1558546788. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4100 LAKE OTIS PKWY STE 312
ANCHORAGE, AK
ZIP 99508-231
Phone: (907) 929-7337

The NPI 1558546788 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/7/2008 and was last updated on 9/24/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086S0120XSurgeryPediatric Surgery43121TENNESSEENo
2208600000XSurgery6550ALASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1MD1272MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.