Miryam Rose Knigge, PA
Individual provider Active NPI Physician Assistant · Dewey, AZ
NPI 1396530697 · NPPES record last updated Oct 21, 2025
Key facts
- NPI
- 1396530697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 11098 (AZ)
- Practice address
- 12075 E State Route 69 Ste B
Dewey, AZ 86327-4569 - Phone
- (928) 772-1673
- Fax
- (928) 772-1674
- NPI assigned
- Apr 9, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Florida International Univ, College of Medicine, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Prescott Healthcare Solutions LLC
Practice addresses (Care Compare)
12075 E State Route 69
Dewey, AZ 86327-4517
Phone (928) 772-1673
3151 N Windsong Dr
Prescott Valley, AZ 86314-2240
Phone (928) 458-7583
3251 N Windsong Dr
Prescott Valley, AZ 86314-1222
Phone (928) 772-2582
3257 N Windsong Dr
Prescott Valley, AZ 86314-1222
Phone (928) 772-2582
450 S Willard St
Suite 103
Cottonwood, AZ 86326-6744
Phone (928) 634-9573
Hospital & facility affiliations
- Yavapai Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250604003304 | AZ | Practitioner - Physician Assistant | 3173032695 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11098 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sundance Medical Associates PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 11098 | AZ | Yes |
Addresses
Primary practice location
12075 E State Route 69 Ste B
Dewey, AZ 86327-4569
Mailing address
12075 E State Route 69 Ste B
Dewey, AZ 86327-4569
Phone (928) 772-1673
Other practice location 1
743 Miller Valley Rd
Prescott, AZ 86301-1813
Phone (928) 777-9600
Other practice location 2
87 S State Route 89
Chino Valley, AZ 86323-5687
Phone (928) 404-1488
Other practice location 3
279 Lawn Way
Miami Springs, FL 33166-5142
Phone (786) 395-0975
Other practice location 4
3251 N Windsong Dr
Prescott Valley, AZ 86314-1222
Phone (928) 772-2582
Other providers in Dewey, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.