DIANA L KOVACICH (MD) – Anesthesiology Physician, NPI 1265631550
Anesthesiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
104 ANESTHESIOLOGY in AK
Provider Addresses for DIANA L KOVACICH (MD)
2485 Chief William Dr
Fairbanks, AK 997094873
Phone: (907) 885-0360
Type: Location
1060 Gaffney Rd Bldg 4076
Fort Wainwright, AK 997035002
Phone: (907) 361-5349
Type: Location
University of Washington Medical Center - Montlake, 1959, Northeast Pacific Street, University District, Seattle, King County, Washington, 98195, United States
C212, BOX 356340
SEATTLE, WA 981950001
Phone: (206) 543-0065
Type: Mailing
1275 SADLER WAY STE 202
FAIRBANKS, AK 997013175
Phone: (907) 452-4101
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: 2011-03-02
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 |
|---|---|---|---|---|
| I20110302000205 | I | Anesthesiology | 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 99709)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ANESTHESIOLOGY | WA | 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 11 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | AK | |
| Certified Registered Nurse Anesthetist (Crna) | ME | |
| Certified Registered Nurse Anesthetist (Crna) | PA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| - | AK | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Certified Registered Nurse Anesthetist (Crna) | IN | |
| Certified Registered Nurse Anesthetist (Crna) | AZ | |
| A N E S T H E S I O L O G Y | TX | |
| - | NC |
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