MRS. JANENE MARIE WIDEN (CCC-A) – Audiologist, NPI 1255391215

MRS. JANENE MARIE WIDEN (CCC-A) is a healthcare provider. based in St louis park, Minnesota. specializing in QUALIFIED AUDIOLOGIST. They hold the professional credentials CCC-A. The NPI Number for MRS. JANENE MARIE WIDEN (CCC-A) is 1255391215

Main info

Female
19 Years Of Experience
Accepts Medicare Assignment
Name
MRS. JANENE MARIE WIDEN (CCC-A)
NPI
1255391215
Phone
Not provided
Address
6465 WAYZATA BLVD
Enumeration Date
24 March 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
PENNSYLVANIA COLLEGE OF OPTOMETRY
Secondary Phone
6512547400
Graduation Year
2007 (19 years ago)
PAC ID
3779651120
Group Practice PAC ID
1759293954
Professional Enrollment ID
I20081013000110
Address ID
MN551305302SA401XXBLVD300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:20State licenses:0Digital endpointsOther names

264 QUALIFIED AUDIOLOGIST in MN

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Provider Addresses for MRS. JANENE MARIE WIDEN (CCC-A)

  • Wayzata Boulevard, Blackstone, Saint Louis Park, Hennepin County, Minnesota, 55416, United States

    STE 315

    ST LOUIS PARK, MN 554261728

    Phone:

    Type: Mailing

  • 3800, Park Nicollet Boulevard, Elmwood, Saint Louis Park, Hennepin County, Minnesota, 55416, United States

    ST LOUIS PARK, MN 554162527

    Phone: (952) 993-1250

    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: 2008-10-13

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
I20081013000110IQualified AudiologistMNTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55426)

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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: 1759293954View full group profile

Reviews

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Frequently asked questions

What identifier follows MRS. JANENE MARIE WIDEN (CCC-A) across health systems?
The NPI 1255391215 uniquely identifies MRS. JANENE MARIE WIDEN (CCC-A) in U.S. healthcare data.
Is MRS. JANENE MARIE WIDEN (CCC-A)'s NPI status active today?
Active status means MRS. JANENE MARIE WIDEN (CCC-A)'s NPI record is not deactivated in the public file.
What type of care does MRS. JANENE MARIE WIDEN (CCC-A) provide?
MRS. JANENE MARIE WIDEN (CCC-A)'s profile centers on Audiologist. Clinical services aligned with this taxonomy classification.
What city is tied to MRS. JANENE MARIE WIDEN (CCC-A)?
The directory associates MRS. JANENE MARIE WIDEN (CCC-A) with St Louis Park, Minnesota. Check all listed addresses for suites or satellite offices.
Who maintains MRS. JANENE MARIE WIDEN (CCC-A)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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