NICOLE ROSE KNISLEY (PA-C) – Medical Physician Assistant, NPI 1194011320

NICOLE ROSE KNISLEY (PA-C) is a healthcare provider. based in Canton, Michigan. specializing in Medical Physician Assistant. They hold the professional credentials PA-C. They hold a License No. 5601006025 (MI). The NPI Number for NICOLE ROSE KNISLEY (PA-C) is 1194011320

Main info

Female
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE ROSE KNISLEY (PA-C)
NPI
1194011320
Phone
(734) 398-7561
Address
1600 S CANTON CENTER RD
Enumeration Date
27 June 2011
Last Update Date
28 July 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7343987557
Graduation Year
2011 (15 years ago)
PAC ID
9032388244
Group Practice PAC ID
3779489281
Professional Enrollment ID
I20110804000321
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

Provider Addresses for NICOLE ROSE KNISLEY (PA-C)

  • 1600 S CANTON CENTER RD

    #140

    CANTON, MI 481881992

    Phone: (734) 398-7561

    Fax: (734) 398-7566

    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)

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: 2011-08-04

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
I20110804000321IPhysician AssistantMITBD

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
99285Emergency department visit with high level of medical decision making7978$0
99284Emergency department visit with moderate level of medical decision making2524$0
View full utilization report →

Insurance plans in this area (ZIP 48188)

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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: 3779489281View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for NICOLE ROSE KNISLEY (PA-C)?
NICOLE ROSE KNISLEY (PA-C) — NPI 1194011320 — is the standard way to identify this listing.
Is NICOLE ROSE KNISLEY (PA-C) still practicing?
NICOLE ROSE KNISLEY (PA-C) is currently listed as active in the public NPI registry.
What is NICOLE ROSE KNISLEY (PA-C)'s primary classification?
Medical Physician Assistant is the headline specialty for NICOLE ROSE KNISLEY (PA-C) here. Clinical services aligned with this taxonomy classification.
Does NICOLE ROSE KNISLEY (PA-C) list a practice location?
Patients near Canton, Michigan may find NICOLE ROSE KNISLEY (PA-C) in results; validate coverage separately.
Is the information about NICOLE ROSE KNISLEY (PA-C) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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