GRACE KANAAN – Physician Assistant, NPI 1124693049

GRACE KANAAN is a healthcare provider. based in Norfolk, Virginia. specializing in PHYSICIAN ASSISTANT. The NPI Number for GRACE KANAAN is 1124693049

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
GRACE KANAAN
NPI
1124693049
Phone
Not provided
Address
6379 CENTER DR
Enumeration Date
24 May 2021
Last Update Date
24 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7576863508
Graduation Year
2021 (5 years ago)
PAC ID
2062817943
Group Practice PAC ID
5092618462
Professional Enrollment ID
I20210817000433
Address ID
VA234348038SU2800XBLVD300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness75
Years active:5State licenses:0Digital endpointsOther names

4,429 PHYSICIAN ASSISTANT in VA

Provider Addresses for GRACE KANAAN

  • 6379 CENTER DR

    NORFOLK, VA 235024102

    Phone:

    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 2 Open Payments records for all available years, with a total value of $131.

Total Amount is formed as General ($131) + Research ($0) + Ownership ($0) = $131.

Last reported payment date: 2024-04-17 • Largest payer in this snapshot: Novartis Pharmaceuticals Corporation ($72).

Total Amount

$131

General + Research + Ownership

Payments

2

Total payment records

General Amount

$131

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2021-08-17

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
I20210817000433IPhysician AssistantVATBD

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
99284Emergency department visit with moderate level of medical decision making5957$0
99285Emergency department visit with high level of medical decision making1414$0
View full utilization report →

Insurance plans in this area (ZIP 23502)

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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: 5092618462View full group profile
NameSpecialtyState
Emergency MedicinePA
Emergency MedicineVA
Physician AssistantWV
Emergency MedicineCT
Emergency MedicineVA
Emergency MedicineOH
Emergency MedicineKY
Physician AssistantVA
Emergency MedicineVA
Emergency MedicineVA

Reviews

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Frequently asked questions

How do I look up GRACE KANAAN by NPI?
Use NPI 1124693049 when you need to reference GRACE KANAAN in forms, claims, or directories.
Does this profile mean GRACE KANAAN is currently active?
Yes — GRACE KANAAN appears active in the national provider directory.
What kind of provider is GRACE KANAAN?
The page reflects Physician Assistant for GRACE KANAAN. Clinical services aligned with this taxonomy classification.
Where does public data place GRACE KANAAN?
The snapshot lists Norfolk, Virginia for GRACE KANAAN; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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