MR. KENNETH T WALLENFELSZ ARNP
NPI 1457649998
Nurse Practitioner - Family in Ketchikan, AK

Q: What is Kenneth Wallenfelsz's NPI number?

The NPI number for Kenneth Wallenfelsz is 1457649998. It was assigned to this individual provider in the NPPES registry on July 19, 2011.

Q: What is Kenneth Wallenfelsz's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since July 19, 2011PECOS Enrolled

3528 TONGASS AVE, KETCHIKAN, AK 99901(907) 220-4447 Get Directions Write a Review

NPPES record last updated: December 16, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 16, 2024, May 8, 2024, Mar 16, 2023 and 1 more (4 updates tracked since 2023).

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About Mr. Kenneth T Wallenfelsz Arnp NPPES

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

MR. KENNETH T WALLENFELSZ ARNP (NPI 1457649998) is an individual family provider in Ketchikan, Alaska, licensed in Alaska (NURU1255) and active in the NPI registry since July 2011. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1457649998

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameMR. KENNETH T WALLENFELSZCredential: ARNP

Location Address3528 TONGASS AVEKetchikan, AK 99901-5635

Mailing Address3528 Tongass AveKetchikan, AK 99901-5635 · (907) 220-4447 · Fax (949) 577-4111

Phone(907) 220-4447

Sole ProprietorYes

Enumeration DateJuly 19, 2011

Last NPPES UpdateDecember 16, 20244 updates tracked since enumeration

NPPES CertifiedDecember 16, 2024

✔ NPI 1457649998 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in AK · NURU1255✔ Licensed in WA · AP60207225✔ Licensed in OR · 201500491NP-PP

Also ListedNurse PractitionerTaxonomy 363L00000X · License AP60207225 (WA)

3528 TONGASS AVE, Ketchikan, AK 99901

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Secondary Practice Locations 2

Location 1834 Sheridan StPort Townsend, WA 98368-2443 · Phone (360) 385-2200 · Fax (360) 385-3095

Location 21274 7th St Ste APort Townsend, WA 98368-2404 · Phone (360) 385-2204 · Fax (360) 385-3095

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Kenneth T Wallenfelsz Arnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

Medicare enrollment records show Kenneth Wallenfelsz reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Southeast Alaska Regional Health Consortium

0.2 mi

Community/Behavioral Health

3050 FIFTH AVE STE 100
Ketchikan, AK 99901

Reassigned Medicare billing, Texas enrollment
640 clinicians in this Medicare group

NPI 1538922455 (907) 966-2411

Sound Physicians Emergency Medicine Of Washington PLLC

621 mi

Emergency Medicine

2000 HOSPITAL DR
Sedro Woolley, WA 98284

Reassigned Medicare billing, Washington enrollment
139 clinicians in this Medicare group

NPI 1629532064 (360) 856-6021

Jefferson County Public Hospital District No 2

629 mi

Rural Health

1010 SHERIDAN ST, SUITE 101
Port Townsend, WA 98368

Reassigned Medicare billing, Washington enrollment
208 clinicians in this Medicare group

NPI 1760433049 (360) 379-8031

U S Health Dept Of Health & Human Services

921 mi

General Acute Care Hospital

760 HOSPITAL CIRCLE
Browning, MT 59417

Reassigned Medicare billing, Texas enrollment
306 clinicians in this Medicare group

NPI 1861409955 (406) 338-6369

Arctic Slope Native Association Ltd

1,330 mi

Critical Access

7000 UULA STREET
Barrow, AK 99723

Reassigned Medicare billing, Alaska enrollment
118 clinicians in this Medicare group

NPI 1306933643 (907) 852-9201

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99901 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

$128.73 typical visit price

range $21.84 – $181.48

Typical copayment $32.18 (range $5.46 – $45.37)

Most-billed visit code 99214

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 10

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

CALM HARBOR HEALTH CLINIC

Nurse Practitioner (Family)