COLIN GRANDGENETT (PA) – Physician Assistant, NPI 1073304721

COLIN GRANDGENETT (PA) is a healthcare provider. based in Wahoo, Nebraska. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. The NPI Number for COLIN GRANDGENETT (PA) is 1073304721

Main info

Male
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
COLIN GRANDGENETT (PA)
NPI
1073304721
Phone
Not provided
Address
649 COUNTY ROAD 14
Enumeration Date
13 May 2025
Last Update Date
31 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4024761455
Graduation Year
2025 (1 year ago)
PAC ID
0244739225
Group Practice PAC ID
6800706672
Professional Enrollment ID
I20250818000251
Address ID
NE685212134LI3100XSTXX401

Contacts

Secure Messaging
Colin.Grandgenett.p1@direct.bluestemlincoln.nextgenshare.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience17
Completeness95
Years active:1State licenses:0Other names

1,397 PHYSICIAN ASSISTANT in NE

Provider Addresses for COLIN GRANDGENETT (PA)

  • 649 COUNTY ROAD 14

    WAHOO, NE 680664034

    Phone:

    Type: Mailing

  • 3100 N 14TH ST

    LINCOLN, NE 685212134

    Phone: (402) 477-6600

    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: 2025-08-18

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
I20250818000251IPhysician AssistantNETBD

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 68066)

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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: 6800706672View full group profile
NameSpecialtyState
Nurse PractitionerNE
Family PracticeNE
Family Practice, Obstetrics/GynecologyNE
Nurse PractitionerNE
Family PracticeNE
Clinical PsychologistNE
Pediatric Medicine, Internal MedicineNE
Family Practice, Emergency MedicineNE
Clinical PsychologistNE
Nurse PractitionerNE

Reviews

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Frequently asked questions

What number should I use to identify COLIN GRANDGENETT (PA) for billing?
Administrative and clinical systems typically use NPI 1073304721 for COLIN GRANDGENETT (PA).
Does the public listing show COLIN GRANDGENETT (PA) as active?
COLIN GRANDGENETT (PA)'s NPI record reflects an active status in NPPES.
What type of care does COLIN GRANDGENETT (PA) provide?
COLIN GRANDGENETT (PA)'s profile centers on Physician Assistant. Clinical services aligned with this taxonomy classification.
Can patients visit COLIN GRANDGENETT (PA) in Wahoo, Nebraska?
For routing, start with Wahoo, Nebraska for COLIN GRANDGENETT (PA), then verify phone and hours locally.
Why is information missing for COLIN GRANDGENETT (PA)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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