KRISTINA L KNISELY (MD) – Pediatrics Physician, NPI 1104881622
Pediatrics Physician
Main info
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for KRISTINA L KNISELY (MD)
Music Box Theatre, 3733, North Southport Avenue, Wrigleyville, Lake View, Lakeview, Chicago, Lake View Township, Cook County, Illinois, 60613, United States
CHICAGO, IL 606776351
Phone: (502) 588-9490
Fax: (502) 272-5116
Type: Mailing
Ring Road, Elizabethtown, Hardin County, Kentucky, 42701, United States
ELIZABETHTOWN, KY 427018968
Phone: (270) 765-2107
Fax: (270) 769-9642
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: 2005-01-12
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 |
|---|---|---|---|---|
| I20050112000650 | I | Pediatric Medicine | KY | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60677)
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