MICHELLE ANN WANNER (PA-C) – Physician Assistant, NPI 1639220080
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MICHELLE ANN WANNER (PA-C)
15115, Dove Trail, Apple Valley, Dakota County, Minnesota, 55124, United States
ATTN: MINUTECLINIC
APPLE VALLEY, MN 551247871
Phone: (866) 387-2727
Type: Mailing
162 Cobblestone Ln
Burnsville, MN 553374578
Phone: (952) 345-3000
Fax: (952) 345-6789
Type: Location
7650 Currell Blvd Ste 260
Woodbury, MN 551258209
Phone: (952) 345-3000
Fax: (952) 345-6789
Type: Location
1630 101st Ave NE Ste 160
Blaine, MN 554493403
Phone: (952) 345-3000
Fax: (952) 345-6789
Type: Location
3435 PROMENADE AVE APT 705
EAGAN, MN 551234413
Phone:
Type: Mailing
7280 E POINT DOUGLAS RD S
COTTAGE GROVE, MN 550163016
Phone: (651) 788-4444
Type: Location
4801 W 81ST ST STE 112
BLOOMINGTON, MN 554371111
Phone: (952) 345-3000
Fax: (952) 345-6789
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: 2008-01-30
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080130000786 | I | Physician Assistant | MN | TBD |
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.
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 55124)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CA | |
| Physician Assistant | MN | |
| Family Practice | MN | |
| Family Practice | MN | |
| - | MN | |
| - | MN | |
| Family Practice | MN | |
| Family Practice | MN | |
| Nurse Practitioner | MN | |
| - | MN |
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