WANDA L WYNN (PA) – Physician Assistant, NPI 1093719650

WANDA L WYNN (PA) is a healthcare provider. based in Lincoln, Nebraska. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 00961 (IA). The NPI Number for WANDA L WYNN (PA) is 1093719650

Main info

Female
32 Years Of Experience
Accepts Medicare Assignment
Name
WANDA L WYNN (PA)
NPI
1093719650
Phone
(402) 488-4321
Address
4210 PIONEER WOODS DR
Enumeration Date
10 June 2005
Last Update Date
8 July 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4024884321
Graduation Year
1994 (32 years ago)
PAC ID
4385705912
Group Practice PAC ID
7214962455
Professional Enrollment ID
I20110826000371
Address ID
NE685067561LI4210XDRXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:21State licenses:1Digital endpointsOther names

1,406 PHYSICIAN ASSISTANT in NE

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Provider Addresses for WANDA L WYNN (PA)

  • Urgent Care Clinic of Lincoln, P.C., 4210, Pioneer Woods Drive, Pioneer Woods, Lincoln, Lancaster County, Nebraska, 68506, United States

    STE A

    LINCOLN, NE 685067561

    Phone: (402) 488-4321

    Fax: (402) 488-4355

    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)

CMS reports 6 Open Payments records for all available years, with a total value of $423.

Total Amount is formed as General ($423) + Research ($0) + Ownership ($0) = $423.

Last reported payment date: 2024-04-04 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($210).

Total Amount

$423

General + Research + Ownership

Payments

6

Total payment records

General Amount

$423

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-04

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2011-08-26

PECOS data refreshed: 2026-06-15

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
I20110826000371IPhysician 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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes285239$0
99203New patient office or other outpatient visit, 30-44 minutes118118$0
36415Insertion of needle into vein for collection of blood sample9991$0
81003Automated urinalysis test9985$0
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count8378$0
View full utilization report →

Insurance plans in this area (ZIP 68506)

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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: 7214962455View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for WANDA L WYNN (PA)?
WANDA L WYNN (PA) — NPI 1093719650 — is the standard way to identify this listing.
Can I rely on WANDA L WYNN (PA) being an active provider?
As of the registry snapshot, WANDA L WYNN (PA) is marked active.
What is WANDA L WYNN (PA)'s primary classification?
Physician Assistant is the headline specialty for WANDA L WYNN (PA) here. Clinical services aligned with this taxonomy classification.
Where is WANDA L WYNN (PA) based?
WANDA L WYNN (PA) is tied to Lincoln, Nebraska in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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