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

Stefan Leo-Nyquist, DO

Individual provider Family Medicine Physician · NPI 1114414265

Stefan Leo-Nyquist, DO is a Family Practice in Fairbanks, Alaska. Graduated from University of New England, College of Osteo Medicine in 2018, 8 years ago. Practices with Tanana Valley Clinic LLC, a 142-clinician group and accepts Medicare assignment. Licensed in Alaska and Oregon.

Years since qualifying
8
Trained at
University of New England, College of Osteo Medicine
Licensed in
AK, OR
In the registry since
2018
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

1919 Lathrop St
Fairbanks, AK 99701-5937
Phone: (907) 458-2619
Fax: (907) 374-1089
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 187313 (AK)
Family Medicine Physician Taxonomy 207Q00000X · Licence PG188468 (OR)

Record details

NPI number1114414265
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 15, 2018
Last updated in NPPESFebruary 23, 2026
Certification dateFebruary 23, 2026
Mailing addressPo Box 73720, Fairbanks, AK 99707-3720

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
Graduated 2018 (8 years in practice)
Group practice Tanana Valley Clinic Llc — 142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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