PENELOPE ANDREA WAGNER (NP) – Gerontology Nurse Practitioner, NPI 1164608477

PENELOPE ANDREA WAGNER (NP) is a healthcare provider. based in Golden, Colorado. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. RN-75898 (CO). The NPI Number for PENELOPE ANDREA WAGNER (NP) is 1164608477

Main info

Female
26 Years Of Experience
Accepts Medicare Assignment
Name
PENELOPE ANDREA WAGNER (NP)
NPI
1164608477
Phone
(303) 949-1250
Address
5920 MCINTYRE ST
Enumeration Date
16 January 2008
Last Update Date
22 January 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7203550539
Graduation Year
2000 (26 years ago)
PAC ID
4284711870
Group Practice PAC ID
0446151617
Professional Enrollment ID
I20080424000539
Address ID
CO802022728DE999XXSTXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:18State licenses:2Digital endpointsOther names

5,201 NURSE PRACTITIONER in CO

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Provider Addresses for PENELOPE ANDREA WAGNER (NP)

  • McIntyre Street, Golden, Jefferson County, Colorado, 80401-4015, United States

    GOLDEN, CO 804037445

    Phone: (303) 949-1250

    Mailing address matches the actual address.

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: 2008-04-24

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
I20080424000539INurse 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
99348Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes16537$0
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes9629$0
99490Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month3416$0
View full utilization report →

Insurance plans in this area (ZIP 80403)

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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: 0446151617View full group profile

Reviews

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Frequently asked questions

Does PENELOPE ANDREA WAGNER (NP) have a public NPI I can cite?
Public records show PENELOPE ANDREA WAGNER (NP) under NPI 1164608477.
Quick check: is PENELOPE ANDREA WAGNER (NP) active?
Public NPPES data shows PENELOPE ANDREA WAGNER (NP) with an active NPI status right now.
Which specialty label fits PENELOPE ANDREA WAGNER (NP)?
NPPES ties PENELOPE ANDREA WAGNER (NP) to Gerontology Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit PENELOPE ANDREA WAGNER (NP) in Golden, Colorado?
For routing, start with Golden, Colorado for PENELOPE ANDREA WAGNER (NP), then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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