Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

David A. Theuret, PHYSICIANASSISTANT

Individual provider Medical Physician Assistant · NPI 1740565936

David A. Theuret, PHYSICIANASSISTANT is a Physician Assistant in Wasilla, Alaska. Qualified in 2016, 10 years ago. Practices with Southcentral Foundation, a 170-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Alaska and California.

Years since qualifying
10
Licensed in
AK, CA
In the registry since
2011
Specialties on file
2
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Practice location Address checks out

1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083
Phone: (907) 631-7800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 900 Main St, Brawley, CA 92227-2630 — (760) 344-6471
  • 450 E Birch St, Calexico, CA 92231-2375 — (760) 550-0253

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 170547 (AK)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 21835 (CA)

Record details

NPI number1740565936
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedOctober 19, 2011
Last updated in NPPESNovember 29, 2023
Certification dateNovember 29, 2023
Mailing address7033 E Tudor Rd, Anchorage, AK 99507-1262

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Southcentral Foundation — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Wasilla