3707 OREGON LLC — NPI 1689095580 (Licensed & Credentialed Assisted Living Facility, Assisted Living, Mental Illness in ANCHORAGE, AK)

CMS-1500 Box 24J / 33a • NPI

1689095580

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

3104A0625X

Licensed & Credentialed Assisted Living Facility, Assisted Living, Mental Illness

Box 32 Service Location & ZIP+4

3707 OREGON DR, ANCHORAGE, AK, 99517-2638

✓ 9-Digit EDI 837 ZIP+4 (99517-2638)

Practice Phone & Referral Fax

(907) 244-9504

Direct NPPES Verification Line

⚠️ HHS OIG LEIE FEDERAL EXCLUSION ALERT: NPI 1689095580 matches an active entry in the HHS Office of Inspector General List of Excluded Individuals/Entities (Sec. 1128(a)(1) — Conviction of Program-Related Crimes (Mandatory 5-Yr Min) — Effective 2026-06-18). Verify before submitting Medicare/Medicaid claims.

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1689095580` (NPI-2 Organization / Facility)
Provider / Legal Name	3707 OREGON LLC
Plain-English Specialty	Licensed & Credentialed Assisted Living Facility, Assisted Living, Mental Illness NUCC Code: `3104A0625X` (Assisted Living Facility, Assisted Living, Mental Illness)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	3707 OREGON DR, ANCHORAGE, AK, 99517-2638
Practice Telephone / Fax	Tel: (907) 244-9504
Administrative Mailing Address	19412 1ST ST, EAGLE RIVER, AK, 99577-7103
Enumeration & Last Sync	Enumerated: 2013-12-18 \| CMS Record Updated: 2013-12-18
Authorized Official	JEFFREY HIETT (President)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

3707 OREGON DR, ANCHORAGE, AK, 99517-2638

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Plain-English Taxonomy & CMS Crosswalk (3104A0625X)

What Does Taxonomy Code 3104A0625X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 3104A0625X translates to:
"Licensed & Credentialed Assisted Living Facility, Assisted Living, Mental Illness"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Assisted Living Facility, Assisted Living, Mental Illness for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (3707 OREGON LLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`3104A0625X` — Assisted Living Facility, Assisted Living, Mental Illness Plain English: Licensed & Credentialed Assisted Living Facility, Assisted Living, Mental Illness	State: AL \| License: `101032` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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3707 OREGON LLC (NPI #1689095580)