JOHN T WALTERS (PA-C) – Medical Physician Assistant, NPI 1215924659

JOHN T WALTERS (PA-C) is a healthcare provider. based in Fairbanks, Alaska. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 142182 (AK). The NPI Number for JOHN T WALTERS (PA-C) is 1215924659

Main info

Male
22 Years Of Experience
Accepts Medicare Assignment
Name
JOHN T WALTERS (PA-C)
NPI
1215924659
Phone
(907) 459-3500
Address
1001 NOBLE ST
Enumeration Date
30 September 2005
Last Update Date
7 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2004 (22 years ago)
PAC ID
2062463391
Group Practice PAC ID
5698056901
Professional Enrollment ID
I20050203000867
Address ID
AK997015998FA1650XSTXX305
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

551 PHYSICIAN ASSISTANT in AK

Loading map...

Provider Addresses for JOHN T WALTERS (PA-C)

  • Tanana Valley Clinc, 1001, Noble Street, South Fairbanks, Fairbanks, Fairbanks North Star Borough, Alaska, 99707, United States

    FAIRBANKS, AK 997014922

    Phone: (907) 459-3500

    Fax: (907) 458-2628

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $20.

Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.

Last reported payment date: 2024-10-09 • Largest payer in this snapshot: Pacira Pharmaceuticals Incorporated ($20).

Total Amount

$20

General + Research + Ownership

Payments

1

Total payment records

General Amount

$20

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2005-02-03

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050203000867IPhysician AssistantAKTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes343322$0
99214Established patient office or other outpatient visit, 30-39 minutes255245$0
J2405Injection, ondansetron hydrochloride, per 1 mg12416$0
87804Detection test by immunoassay with direct visual observation for influenza virus10452$0
J1885Injection, ketorolac tromethamine, per 15 mg9835$0
View full utilization report →

Insurance plans in this area (ZIP 99701)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5698056901View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)LA
Certified Registered Nurse Anesthetist (Crna)AK
A N E S T H E S I O L O G YMD
P S Y C H I A T R YWA
H O S P I T A L I S TCA
Emergency MedicineAK
U R O L O G YAK
Certified Registered Nurse Anesthetist (Crna)ID
Family PracticeAK
-AK

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What number should I use to identify JOHN T WALTERS (PA-C) for billing?
Administrative and clinical systems typically use NPI 1215924659 for JOHN T WALTERS (PA-C).
Is JOHN T WALTERS (PA-C) currently accepting referrals based on NPI status?
Registry metadata lists JOHN T WALTERS (PA-C) as active.
How should patients interpret JOHN T WALTERS (PA-C)'s specialty?
The extract shows Medical Physician Assistant for JOHN T WALTERS (PA-C). Clinical services aligned with this taxonomy classification.
Is JOHN T WALTERS (PA-C) tied to Fairbanks, Alaska?
If you are local to Fairbanks, Alaska, JOHN T WALTERS (PA-C) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

Similar Providers

THOMAS MANFORD III DALE (PA)

Medical Physician Assistant
607, Old Steese Highway, Hamilton Acres, Fairbanks, Fairbanks North Star Borough, Alaska, 99701, United States
NPI: 1588651053

LAURA CATALANO (PA-C)

Medical Physician Assistant
1717, West Cowles Street, South Fairbanks, Fairbanks, Fairbanks North Star, Alaska, 99701, United States
NPI: 1942299144
2003, Carr Avenue, Aurora, Fairbanks, Fairbanks North Star Borough, Alaska, 99709, United States
NPI: 1679563829

MATHILDA HUNTINGTON (PA-C)

Medical Physician Assistant
1717, West Cowles Street, South Fairbanks, Fairbanks, Fairbanks North Star, Alaska, 99701, United States
NPI: 1366423204

MR. JAMES ROBERT ANDRULLI (PA-C)

Medical Physician Assistant
1408, 19th Avenue, South Fairbanks, Fairbanks, Fairbanks North Star, Alaska, 99701, United States
NPI: 1710968656
201, 1st Avenue, Slaterville, Fairbanks, Fairbanks North Star, Alaska, 99701, United States
NPI: 1023091618

NICOLLE KAHL WISNIEWSKI (MPAS, PA-C)

Medical Physician Assistant
1919, Lathrop Street, South Fairbanks, Fairbanks, Fairbanks North Star, Alaska, 99701, United States
NPI: 1871579961

STEPHANIE GHO (PA-C)

Medical Physician Assistant
2555, Phillips Field Road, Slaterville, Fairbanks, Fairbanks North Star, Alaska, 99709, United States
NPI: 1306811732