NPIMap

Individual provider Active NPI

Julianne Diana Knezovich, PA-C

  • Physician Assistant
  • Port Angeles, WA
National Provider Identifier
1467928820
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61464736 Issued in WA
Practice address
907 Georgiana St
Port Angeles, WA 98362-3911
Phone
(360) 565-0550
Fax
(360) 565-0551
NPI assigned
Oct 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OA004719 PA
Physician Assistant 363A00000X PA61464736 WA Primary

Addresses

Primary practice location

907 Georgiana St
Port Angeles, WA 98362-3911

Mailing address

PO Box 850
Port Angeles, WA 98362-0146
Phone (360) 565-0550

Other practice location 1

835 Hospital Rd
Indiana, PA 15701-3629
Phone (724) 357-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190408001529 PA Practitioner - Physician Assistant 0941541692 Reassigns benefits to 1 organization
I20240104003587 WA Practitioner - Physician Assistant 0941541692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Suite 850
Port Angeles, WA 98362-0146

Hospital & facility affiliations

  • Olympic Medical Center Hospital, Port Angeles, WA, CCN 500072
  • Indiana Regional Medical Center Hospital, Indiana, PA, CCN 390173

Merit-based Incentive Payment System (MIPS)

Final score
81.56 of 100Reported as group
Quality
80.73
Promoting interoperability
80
Improvement activities
40
Cost
74.47

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
OA004719PAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: jknezovich3065558@wm.providencedirect.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1467928820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983620146",
            "telephone_number": "360-565-0550",
            "fax_number": "360-565-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 GEORGIANA ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623911",
            "telephone_number": "360-565-0550",
            "fax_number": "360-565-0551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Indiana",
            "state": "PA",
            "postal_code": "157013629",
            "country_code": "US",
            "telephone_number": "724-357-7000",
            "fax_number": "724-357-7479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNEZOVICH",
        "first_name": "JULIANNE",
        "middle_name": "DIANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA004719",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61464736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

Verify at the official NPI Registry.