Deactivated NPI 1417070905 Deactivated / Inactive NPI Male Practitioner

Dr. Elliott B Gagnon , MD

Plastic Surgery • Wasilla, AK

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Elliott Gagnon has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 09, 2007

NPI Deactivation Date January 24, 2022

Total Practice Duration ~15 Years of Practice (2007 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Elliott Gagnon, MD was a registered Plastic Surgery practicing in Wasilla, AK. Throughout an active medical career spanning 15 years, Dr. Gagnon provided care at the practice location at 950 E BOGARD RD until profile deactivation on 2022-01-24.

Historical Medicare Part B clinical services included new patient outpatient office visit, established patient outpatient office visit, tangential biopsy of single skin lesion. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

950 E Bogard Rd
Suite 209

Wasilla, AK 996547184

Telephone 9073574550

Fax 9073574552

Associated Practice Facility / Clinic

🏢 Mat-Su Valley Ii Llc Facility NPI 1275718769

Specialty Benchmarks & Practice Insights

Comparative analytics for Plastic Surgery in Wasilla, AK

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 15.5 Yrs

Regional Practice Density

1 Specialists

Practicing in Wasilla, AK (10 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

75.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	129	129	$295.80	$145.86
99213 Established patient office or other outpatient visit, typically 15 minutes	101	73	$199.92	$118.95
11102 Tangential biopsy of single skin lesion	47	43	$510.43	$122.85
11103 Biopsy of related skin growth, each additional growth	28	19	$270.30	$64.83
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	14	13	$1846.20	$300.50

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	182	118	$199.92	$92.53
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	153	153	$295.80	$134.00
11102 Tangential biopsy of single skin lesion	64	55	$499.80	$103.61
11103 Biopsy of related skin growth, each additional growth	41	28	$270.30	$62.53
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	11	11	$1581.00	$295.73
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	11	11	$1846.20	$262.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	167	109	$201.63	$94.76
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	144	144	$297.33	$137.63
11102 Tangential biopsy of single skin lesion	55	51	$490.00	$110.06
11103 Biopsy of related skin growth, each additional growth	29	23	$265.00	$64.25
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	18	18	$1342.33	$232.68
11442 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	14	13	$946.43	$125.16
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	13	12	$1716.77	$357.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	262	109	$195.27	$90.86
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	128	128	$289.18	$133.69
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	79	26	$135.00	$53.58
99231 Follow-up hospital inpatient care per day, typically 15 minutes	51	14	$239.00	$51.85
11100 Biopsy of single growth of skin and/or tissue	38	35	$550.00	$111.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	316	127	$188.00	$93.26
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	166	166	$285.00	$137.37
11100 Biopsy of single growth of skin and/or tissue	50	44	$502.00	$118.43
99213 Established patient office or other outpatient visit, typically 15 minutes	42	12	$188.00	$69.01
99231 Follow-up hospital inpatient care per day, typically 15 minutes	39	14	$239.00	$53.17
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	17	14	$280.00	$138.12
11101 Biopsy of each additional growth of skin and/or tissue	17	13	$200.00	$41.29
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	15	12	$135.00	$54.31
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	12	11	$1498.00	$262.10

Medical Specialties & State Licenses

Plastic Surgery Primary Specialty

NUCC Taxonomy Code: 208200000X

State License CA A108504

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

12 Associated Practitioners

Dr. Joseph Wang , DDS

Dentist

NPI 1174746689

Doctor of Dental Surgery

Dr. Megan Nystrom , DO

Family Medicine

NPI 1255522215

Doctor of Osteopathic Medicine (D.O.)

Shawn Roberts , MS FNP

Nurse Practitioner - Family

NPI 1295878429

MSFNP

Patricia Payne , ANP

Nurse Practitioner

NPI 1346776150

Adult Nurse Practitioner

Rebecca Moore , RD, CDE, LD

Dietitian, Registered

NPI 1497900278

Registered Dietitian, Certified Diabetes Educator, Licensed Dietitian

Dr. Elowyn Smith , DO

Pediatrics

NPI 1568476596

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

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NPI Profile Deactivated January 24, 2022

Record deactivated on January 24, 2022

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NPI Profile Active February 23, 2016

NPI status registered as active in NPPES database

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Updated Practice Location February 23, 2016

Registered at 950 E BOGARD RD, SUITE 209, WASILLA, AK 996547184 (Tel: 9073574550)

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Updated Business Mailing Address February 23, 2016

Registered at 950 E BOGARD RD, SUITE 209, WASILLA, AK 996547184 (Tel: 9073574550)

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Provider Name / Credentials Updated February 23, 2016

Recorded as ELLIOTT GAGNON, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 23, 2016

Plastic Surgery (License #A108504 in CA)

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Initial NPI Registration & Enumeration April 09, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1417070905

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 09, 2007

Last Update: February 23, 2016

Deactivation Date: January 24, 2022

Update or Correct Profile

Mailing Address

950 E Bogard Rd, Suite 209

Wasilla, AK 996547184

Phone: 9073574550

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.