DOMENICA M KNUDSEN – Clinical Psychologist, NPI 1336109230

DOMENICA M KNUDSEN is a healthcare provider. based in Media, Pennsylvania. specializing in CLINICAL PSYCHOLOGIST. They hold a License No. PS008547L (PA). The NPI Number for DOMENICA M KNUDSEN is 1336109230

Main info

Female
Sole Proprietor
31 Years Of Experience
Accepts Medicare Assignment
Name
DOMENICA M KNUDSEN
NPI
1336109230
Phone
(610) 565-6843
Address
280 N PROVIDENCE RD
Enumeration Date
24 March 2006
Last Update Date
7 June 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6105656843
Graduation Year
1995 (31 years ago)
PAC ID
6608939095
Professional Enrollment ID
I20100908001022
Address ID
PA175369647KI6150XRDXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:20State licenses:2Digital endpointsOther names

1,669 CLINICAL PSYCHOLOGIST in PA

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Provider Addresses for DOMENICA M KNUDSEN

  • 280, North Providence Road, Media, Delaware County, Pennsylvania, 19063, United States

    MEDIA, PA 190633527

    Phone: (610) 565-6843

    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: 2010-09-08

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
I20100908001022IClinical PsychologistPATBD

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 19063)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for DOMENICA M KNUDSEN?
DOMENICA M KNUDSEN — NPI 1336109230 — is the standard way to identify this listing.
Is DOMENICA M KNUDSEN listed as active for patients and plans?
The listing shows DOMENICA M KNUDSEN as active in the NPI system.
What healthcare role does DOMENICA M KNUDSEN hold?
Scheduling teams often label DOMENICA M KNUDSEN under Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Does DOMENICA M KNUDSEN list a practice location?
Patients near Media, Pennsylvania may find DOMENICA M KNUDSEN in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.