JASON BEAU DELUISA ANP NPI 1629200894

NPI Information

NPI: 1629200894
Provider Name: JASON BEAU DELUISA, ANP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Organization: PRESBYTERIAN MEDICAL SERVICES

PECOS Registration: Yes

Address:
3801 LAKE OTIS PKWY STE 112
ANCHORAGE, AK
ZIP 99508
Phone: (907) 202-5577
Get Directions

Jason Beau Deluisa, ANP is a psychiatric/mental health nurse practitioner in Anchorage, AK with 6 years of experience. Jason Beau Deluisa, ANP NPI is 1629200894. 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:

3801 LAKE OTIS PKWY STE 112
ANCHORAGE, AK
ZIP 99508-234
Phone: (907) 202-5577
Fax: (907) 865-2433

The NPI 1629200894 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 8/20/2009 and was last updated on 9/16/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	117659	ALASKA	Yes
2	363LF0000X	Nurse Practitioner	Family	117659	ALASKA	No
3	363LF0000X	Nurse Practitioner	Family	CNP-01518	NEW MEXICO	No

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	37805771	MEDICAID	NEW MEXICO
2	1666771	MEDICAID	ALASKA

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

NPI Synchronization or Removal

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.

« Previous NPI

Next NPI »