Eagle River Dermatology Inc
NPI 1750880654 · Dermatology Physician · Eagle River, AK
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Eagle River Dermatology Inc is a Dermatology Physician organization in Eagle River, AK (NPI 1750880654).
Provider details
- NPI number
- 1750880654
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Lindsay Proctor, Office Manager(907) 694-3303
- License
- AK503 (AK)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Eagle River Dermatology Inc
Registry dates
- Enumerated
- 2018-02-06
- Last updated
- 2018-02-06
Frequently asked questions
- What is Eagle River Dermatology Inc's NPI number?
- Eagle River Dermatology Inc's National Provider Identifier (NPI) is 1750880654, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Eagle River Dermatology Inc?
- Eagle River Dermatology Inc is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Eagle River Dermatology Inc located?
- Eagle River Dermatology Inc's practice location on file with NPPES is 16839 Park Place St, Eagle River, AK 99577.
- What is Eagle River Dermatology Inc's phone number?
- The practice phone number listed in the NPPES registry for Eagle River Dermatology Inc is (907) 694-3303.
- Does Eagle River Dermatology Inc accept Medicare?
- Eagle River Dermatology Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Eagle River Dermatology Inc?
- The authorized official listed on Eagle River Dermatology Inc's NPPES record is Lindsay Proctor, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Eagle River Dermatology Inc's NPI active?
- Yes — Eagle River Dermatology Inc's NPI (1750880654) is active in the NPPES registry as of the last update on 2018-02-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.