DR. CORRINE LEISTIKOW (M.D.) – Family Medicine Physician, NPI 1417922774
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. CORRINE LEISTIKOW (M.D.)
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) 459-3588
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $69.
Total Amount is formed as General ($69) + Research ($0) + Ownership ($0) = $69.
Last reported payment date: 2023-07-24 • Largest payer in this snapshot: PFIZER INC. ($69).
Total Amount
$69
General + Research + Ownership
Payments
3
Total payment records
General Amount
$69
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-07-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $69 |
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: 2006-06-27
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 |
|---|---|---|---|---|
| I20060627000044 | I | Family Practice | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 630 | 416 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 334 | 263 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 233 | 233 | $0 |
| G0008 | Administration of influenza virus vaccine | 71 | 71 | $0 |
| G0009 | Administration of pneumococcal vaccine | 49 | 49 | $0 |
Insurance plans in this area (ZIP 99701)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | AK | 90670 | Pneumococcal vaccine for injection into muscle | 46 | 46 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| 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 Y | MD | |
| P S Y C H I A T R Y | WA | |
| H O S P I T A L I S T | CA | |
| Emergency Medicine | AK | |
| U R O L O G Y | AK | |
| Family Practice | AK | |
| - | AK | |
| P S Y C H I A T R Y | HI |
Reviews
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