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ALICE RAVEN KENNEALLY PA-C
NPI 1295565471
Physician Assistant in Palmer, AK

Active since August 03, 2024PECOS EnrolledAccepts Medicare Assignment
425 E DAHLIA AVE, PALMER, AK 99645(907) 376-2411 Get Directions Write a Review

NPPES record last updated: April 30, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Alice Raven Kenneally Pa-c NPPES

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

ALICE RAVEN KENNEALLY PA-C (NPI 1295565471) is an individual physician assistant in Palmer, Alaska, licensed in Alaska (233490) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS and is a graduate of East Carolina University School Of Dentistry (2024).

NPPES Registry Identity

NPI1295565471
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameALICE RAVEN KENNEALLYCredential: PA-C
Location Address425 E DAHLIA AVEPalmer, AK 99645-6463
Mailing Address425 E Dahlia AvePalmer, AK 99645-6463 · (907) 376-2411 · Fax (907) 352-3301
Phone(907) 376-2411
Sole ProprietorNo
Medical School CMSEast Carolina University School Of DentistryGraduated 2024
Enumeration DateAugust 3, 2024
Last NPPES UpdateApril 30, 2025
NPPES CertifiedApril 30, 2025
✔ NPI 1295565471 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in AK · 233490
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
425 E DAHLIA AVE, Palmer, AK 99645
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Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Alice Raven Kenneally Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID345759502
PECOS Enrollment IDI20250530002420
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99645 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$111.57 typical visit price
range $71.33 – $222.64
Typical copayment $27.89 (range $17.83 – $55.66)
Most-billed visit code 99203
Established Patient
$90.40 typical visit price
range $21.84 – $181.48
Typical copayment $22.60 (range $5.46 – $45.37)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. KATHLEEN MARIE MEGHA HAMMAKER M.S.,R.N.,A.N.P.
Nurse Practitioner (Psychiatric/Mental Health)
425 E DAHLIA AVE, STE MB
PALMER, AK 99645
Matanuska-Susitna Borough (907) 746-4412
MRS. ELENA P. MORRIS MSW
Social Worker
425 E DAHLIA AVE
PALMER, AK 99645
Matanuska-Susitna Borough (907) 376-2411
FAMILY HEALTH CENTER, PC
Nurse Practitioner (Family)
425 E DAHLIA AVE, SUITE L
PALMER, AK 99645
Matanuska-Susitna Borough (907) 745-1777
SUSAN M LEMAGIE MD
Obstetrics & Gynecology (Gynecology)
425 E DAHLIA AVE, SUITE J
PALMER, AK 99645
Matanuska-Susitna Borough (907) 745-8379
NANCY GAY STONE LCSW
Counselor (Mental Health)
425 E DAHLIA AVE
PALMER, AK 99645
Matanuska-Susitna Borough (907) 376-2411

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 Alice Kenneally's NPI number?

The NPI number for Alice Kenneally is 1295565471. It was assigned to this individual provider in the NPPES registry on August 3, 2024.

Where is Alice Kenneally located?

Alice Kenneally practices at 425 E Dahlia Ave, Palmer, AK 99645. The listed phone number is (907) 376-2411.

What is Alice Kenneally's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Alice Kenneally enrolled in Medicare?

Yes. Alice Kenneally is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Alice Kenneally accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Alice Kenneally 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 Alice Kenneally was last updated on April 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.