HOLLY HOLLEMBEAK (NURSE PRACTITIONER) – Family Nurse Practitioner, NPI 1063071496

HOLLY HOLLEMBEAK (NURSE PRACTITIONER) is a healthcare provider. based in Hugo, Colorado. specializing in NURSE PRACTITIONER. They hold the professional credentials NURSE PRACTITIONER. They hold a License No. 0994689 (CO). The NPI Number for HOLLY HOLLEMBEAK (NURSE PRACTITIONER) is 1063071496

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
HOLLY HOLLEMBEAK (NURSE PRACTITIONER)
NPI
1063071496
Phone
(719) 743-2155
Address
111 6TH ST
Enumeration Date
10 June 2019
Last Update Date
15 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7197432063
Graduation Year
2019 (7 years ago)
PAC ID
8729317045
Group Practice PAC ID
8729987219
Professional Enrollment ID
I20190912000959
Address ID
CO801039727BY404XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:7State licenses:1Digital endpointsOther names

5,201 NURSE PRACTITIONER in CO

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Provider Addresses for HOLLY HOLLEMBEAK (NURSE PRACTITIONER)

  • Lincoln Community Hospital, 111, 6th Street, Hugo, Lincoln County, Colorado, 80821, United States

    HUGO, CO 808212002

    Phone: (719) 743-2155

    Type: Mailing

  • 111 6th St

    Hugo, CO 808212002

    Phone: (719) 743-2155

    Type: Location

  • PO BOX 248

    HUGO, CO 808210248

    Phone: (719) 743-2421

    Fax: (719) 743-2355

    Type: Mailing

  • 404 E FRONT ST

    BYERS, CO 801039727

    Phone: (303) 822-5100

    Fax: (303) 822-5106

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-09-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190912000959INurse PractitionerCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes7748$0
99214Established patient office or other outpatient visit, 30-39 minutes5136$0
99204New patient office or other outpatient visit, 45-59 minutes2222$0
99203New patient office or other outpatient visit, 30-44 minutes1818$0
View full utilization report →

Insurance plans in this area (ZIP 80821)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8729987219View full group profile
NameSpecialtyState
Nurse PractitionerCO
Colorectal Surgery (Proctology), General SurgeryCO
-AZ
Family PracticeCO
Nurse PractitionerCO
Hospitalist, Family PracticeCO
-CO
Mental Health CounselorCO
Family PracticeCO
Nurse PractitionerCO

Reviews

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Frequently asked questions

What is the registry number for HOLLY HOLLEMBEAK (NURSE PRACTITIONER)?
The registry entry for HOLLY HOLLEMBEAK (NURSE PRACTITIONER) shows NPI 1063071496.
Is HOLLY HOLLEMBEAK (NURSE PRACTITIONER) currently accepting referrals based on NPI status?
Registry metadata lists HOLLY HOLLEMBEAK (NURSE PRACTITIONER) as active.
How should patients interpret HOLLY HOLLEMBEAK (NURSE PRACTITIONER)'s specialty?
The extract shows Family Nurse Practitioner for HOLLY HOLLEMBEAK (NURSE PRACTITIONER). Clinical services aligned with this taxonomy classification.
Which community is linked to HOLLY HOLLEMBEAK (NURSE PRACTITIONER)?
HOLLY HOLLEMBEAK (NURSE PRACTITIONER) shows a connection to Hugo, Colorado in registry-derived data.
Can I export HOLLY HOLLEMBEAK (NURSE PRACTITIONER)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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