DR. PETER PAUL CANNAVA (PH.D.) – Psychologist, NPI 1508997867

DR. PETER PAUL CANNAVA (PH.D.) is a healthcare provider. based in Soldotna, Alaska. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. 516 (AK). The NPI Number for DR. PETER PAUL CANNAVA (PH.D.) is 1508997867

Main info

Male
26 Years Of Experience
Accepts Medicare Assignment
Name
DR. PETER PAUL CANNAVA (PH.D.)
NPI
1508997867
Phone
(907) 260-7300
Address
PO BOX 2949
Enumeration Date
8 March 2007
Last Update Date
25 August 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9072623119
Graduation Year
2000 (26 years ago)
PAC ID
5193780088
Group Practice PAC ID
8426043894
Professional Enrollment ID
I20041119000510
Address ID
AK996697648SO230XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

75 CLINICAL PSYCHOLOGIST in AK

Provider Addresses for DR. PETER PAUL CANNAVA (PH.D.)

  • PO BOX 2949

    SOLDOTNA, AK 996692949

    Phone: (907) 260-7300

    Fax: (907) 260-7301

    Type: Mailing

  • 230 E MARYDALE AVE

    SUITE 1

    SOLDOTNA, AK 996697648

    Phone: (907) 260-3691

    Fax: (907) 260-7301

    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: 2004-11-19

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
I20041119000510IClinical PsychologistAKTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 99669)

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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: 8426043894View full group profile
NameSpecialtyState
-AK
Mental Health CounselorAK
Nurse PractitionerAK
Family PracticeAK
Physician AssistantCO
-AK
O P T O M E T R YCA
Nurse PractitionerAK
Nurse PractitionerFL
P S Y C H I A T R YWA

Reviews

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Frequently asked questions

What is DR. PETER PAUL CANNAVA (PH.D.)'s NPI number?
DR. PETER PAUL CANNAVA (PH.D.)'s NPI is 1508997867 — the number used across U.S. healthcare to identify this provider.
Is DR. PETER PAUL CANNAVA (PH.D.) shown as active in public data?
Registry records indicate DR. PETER PAUL CANNAVA (PH.D.) maintains an active NPI.
What clinical focus is listed for DR. PETER PAUL CANNAVA (PH.D.)?
At a glance, DR. PETER PAUL CANNAVA (PH.D.) is tied to Psychologist. Clinical services aligned with this taxonomy classification.
Is DR. PETER PAUL CANNAVA (PH.D.) located near Soldotna?
DR. PETER PAUL CANNAVA (PH.D.) currently maps to Soldotna, Alaska in this extract.
When was this NPI issued?
Enumeration for DR. PETER PAUL CANNAVA (PH.D.) is noted as March 8, 2007 where the registry provides it.

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