Atlas Medical ACO LLC
NPI 1629807086ActiveOrganization· Clinic/Center· Wasilla, AK
Clinic/Center in Wasilla, Alaska, registered in NPPES in August 2024, part of Atlas Medical ACO LLC. The authorized official on file is Gregory Chad Mangum, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1629807086 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Atlas Medical ACO LLC |
| NPI issued | Aug 1, 2024 |
| Last updated in NPPES | Oct 17, 2024 |
| Certified by provider | Oct 17, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center Primary | 261Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AK) |
|---|
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