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NICOLLE KAHL WISNIEWSKI MPAS PA-C NPI 1871579961


NPI Information

NPI: 1871579961
Provider Name: NICOLLE KAHL WISNIEWSKI, MPAS, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Organization: TANANA VALLEY CLINIC LLC

PECOS Registration: Yes

Address:
1001 NOBLE ST
FAIRBANKS, AK
ZIP 99701
Phone: (907) 459-3500
Get Directions

Nicolle Kahl Wisniewski, MPAS, PA-C is a surgical physician assistant in Fairbanks, AK with 21 years of experience. Nicolle Kahl Wisniewski, MPAS, PA-C NPI is 1871579961. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1001 NOBLE ST
FAIRBANKS, AK
ZIP 99701-922
Phone: (907) 459-3500
Fax: (907) 458-2653

The NPI 1871579961 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)
  • X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • X-ray of knee, 3 views (HCPCS:73562)

The enumeration date for this NPI number is 12/20/2005 and was last updated on 12/10/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363AM0700XPhysician AssistantMedical1000ALASKANo
2363AS0400XPhysician AssistantSurgical9868MINNESOTANo
3363AS0400XPhysician AssistantSurgical1000ALASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1MH2453924OTHERALASKADEA
21575427MEDICAIDALASKA
3991491900MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.