DR. ALISE MAGNUSON (M.D.) – Pediatrics Physician, NPI 1508864638
Pediatrics Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. ALISE MAGNUSON (M.D.)
4615, Huntridge Road, Huntridge, Roanoke County, Virginia, 24012, United States
ROANOKE, VA 240128510
Phone: (540) 977-0900
Fax: (540) 977-0550
Type: Location
146 S MAIN ST
LEXINGTON, VA 244502356
Phone: (540) 462-6270
Fax: (540) 319-5172
Type: Location
1103 CIRCULO MERCADO
NOGALES, AZ 856486248
Phone: (520) 281-1550
Fax: (520) 281-1112
Type: Location
1103 Circulo Mercado
Nogales, AZ 856486248
Phone: (520) 281-1550
Fax: (520) 281-1112
Type: Location
213 S JEFFERSON ST STE 1006
ROANOKE, VA 240111713
Phone:
Type: Mailing
825 N GRAND AVE STE 100
NOGALES, AZ 856211061
Phone: (520) 281-1550
Fax: (520) 281-1112
Type: Mailing
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: 2021-11-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20051107000839 | I | Pediatric Medicine | VA | TBD |
| I20211130003217 | I | Pediatric Medicine | AZ | 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 24012)
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Reviews
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