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MARK T. KOWAL MD PC
NPI 1205112240
Clinic/Center in Fairbanks, AK

Active since October 21, 2011
1919 LATHROP ST, SUITE 202, FAIRBANKS, AK 99701(907) 451-5507(907) 451-5590 Get Directions Write a Review

NPPES record last updated: December 27, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mark T. Kowal Md Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK T. KOWAL MD PC (NPI 1205112240) is a healthcare organization registered as a clinic/center in Fairbanks, Alaska and active in the NPI registry since October 2011. The organization lists Mark Timothy Kowal, General Surgeon, as its authorized official.

NPPES Registry Identity

NPI1205112240
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameMARK T. KOWAL MD PC
Location Address1919 LATHROP ST, SUITE 202Fairbanks, AK 99701-5937
Mailing Address1919 Lathrop St, Suite 202Fairbanks, AK 99701-5937 · (907) 451-5507 · Fax (907) 451-5590
Phone(907) 451-5507
Fax(907) 451-5590
Organization SubpartNo
Authorized OfficialMark Timothy KowalGeneral Surgeon · (907) 451-5507
Enumeration DateOctober 21, 2011
Last NPPES UpdateDecember 27, 2016
✔ NPI 1205112240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in AK · 7319
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
1919 LATHROP ST, Fairbanks, AK 99701
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark T. Kowal Md Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateAlaskaEnrollment IDO20120131000537Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mark T. Kowal MD PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mark Kowal, M.D.
General Surgery
NPI 1285855239
1919 LATHROP ST STE 202
Fairbanks, AK 99701
(907) 451-5507
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark T. Kowal MD PC's NPI number?

The NPI number for Mark T. Kowal MD PC is 1205112240. It was assigned to this organization in the NPPES registry on October 21, 2011.

Where is Mark T. Kowal MD PC located?

Mark T. Kowal MD PC is located at 1919 Lathrop St Suite 202, Fairbanks, AK 99701. The listed phone number is (907) 451-5507.

What is Mark T. Kowal MD PC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Mark T. Kowal MD PC enrolled in Medicare?

Yes. Mark T. Kowal MD PC is registered in the Medicare PECOS enrollment system.

When is Mark T. Kowal MD PC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Alaska, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Mark T. Kowal MD PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (General Surgery) reassigns their Medicare billing to Mark T. Kowal MD PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Mark T. Kowal MD PC accept?

Health plans from Moda Health Plan, Inc. and Premera Blue Cross Blue Shield of Alaska list Mark T. Kowal MD PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mark T. Kowal MD PC was last updated on December 27, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.