NICOLLE KAHL WISNIEWSKI (MPAS, PA-C) – Medical Physician Assistant, NPI 1871579961
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
551 PHYSICIAN ASSISTANT in AK
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Provider Addresses for NICOLLE KAHL WISNIEWSKI (MPAS, PA-C)
1919, Lathrop Street, South Fairbanks, Fairbanks, Fairbanks North Star, Alaska, 99701, United States
STE # 105
FAIRBANKS, AK 997015937
Phone: (907) 451-6561
Fax: (907) 452-8912
Type: Mailing
1001, Noble Street, South Fairbanks, Fairbanks, Fairbanks North Star, Alaska, 99701, United States
FAIRBANKS, AK 997014922
Phone: (907) 459-3500
Fax: (907) 458-2653
Type: Location
1001 Noble St
Fairbanks, AK 997014922
Phone: (907) 459-3500
Fax: (907) 458-2653
Type: Location
3801 LAKE OTIS PKWY STE 300
ANCHORAGE, AK 995085234
Phone: (907) 562-2277
Fax: (907) 563-3460
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $145.
Total Amount is formed as General ($145) + Research ($0) + Ownership ($0) = $145.
Last reported payment date: 2024-09-05 • Largest payer in this snapshot: Solventum Corporation ($74).
Total Amount
$145
General + Research + Ownership
Payments
2
Total payment records
General Amount
$145
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Solventum Corporation | $74 |
| SI-BONE, INC. | $71 |
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: 2011-12-05
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 |
|---|---|---|---|---|
| I20111205000941 | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 184 | 168 | $0 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 103 | 25 | $0 |
| 73564 | X-ray of knee, 4 or more views | 93 | 87 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 83 | 83 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 55 | 52 | $0 |
Insurance plans in this area (ZIP 99701)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Occupational Therapist In Private Practice | AK | |
| Physician Assistant | AK | |
| Orthopedic Surgery | AK | |
| P O D I A T R Y | TX | |
| Family Practice | WA | |
| Nurse Practitioner | AK | |
| Physician Assistant | AK | |
| - | AK | |
| Family Practice, Osteopathic Manipulative Medicine | AK | |
| Pain Management, Physical Medicine And Rehabilitation | AK |
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