DANIEL THOMAS KNUDSEN (PA-C) – Physician Assistant, NPI 1124537550
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
551 PHYSICIAN ASSISTANT in AK
Provider Addresses for DANIEL THOMAS KNUDSEN (PA-C)
3066 E Meridian Park Loop Ste 1
Wasilla, AK 996547254
Phone: (907) 357-9590
Type: Location
786 D ST
JOINT BASE ELMENDORF RICHARDSON, AK 99508
Phone: (907) 384-0600
Type: Location
19040, Trail Bay Drive, Eagle Crossing Homeowner's Association, Eagle River, Anchorage, Alaska, 99577, United States
EAGLE RIVER, AK 995778589
Phone: (646) 207-4642
Type: Mailing
4076 NEELEY RD
FORT WAINWRIGHT, AK 997037954
Phone: (907) 384-0600
Type: Mailing
Madigan Army Medical Center, 9040, Jackson Avenue, Tacoma, Pierce County, Washington, 98431, United States
TACOMA, WA 984313702
Phone: (646) 207-4642
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-03-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240311001960 | I | Physician Assistant | AK | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 99654)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | GA | |
| Certified Nurse Midwife (Cnm) | AK | |
| - | CO | |
| General Surgery | AK | |
| - | AL | |
| Physical Medicine And Rehabilitation, Sports Medicine | AK | |
| Physician Assistant | AK | |
| General Surgery | AK | |
| - | AK | |
| Physician Assistant | WA |
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