MICHAEL NATHEN WARREN (MPAS, PA-C) – Physician Assistant, NPI 1114329810

MICHAEL NATHEN WARREN (MPAS, PA-C) is a healthcare provider. based in Fayetteville, New York. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials MPAS, PA-C. They hold a License No. 8177613-4810 (UT). The NPI Number for MICHAEL NATHEN WARREN (MPAS, PA-C) is 1114329810

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
MICHAEL NATHEN WARREN (MPAS, PA-C)
NPI
1114329810
Phone
(315) 637-9116
Address
212 HIGHBRIDGE ST
Enumeration Date
24 September 2014
Last Update Date
8 September 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4356735373
Graduation Year
2018 (8 years ago)
PAC ID
2365707783
Group Practice PAC ID
0042573438
Professional Enrollment ID
I20220217001006
Address ID
UT847904495ST1490XDRXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness75
Years active:11State licenses:2Digital endpointsOther names

13,243 PHYSICIAN ASSISTANT in NY

Provider Addresses for MICHAEL NATHEN WARREN (MPAS, PA-C)

  • 212 HIGHBRIDGE ST

    FAYETTEVILLE, NY 130661981

    Phone: (315) 637-9116

    Fax: (315) 637-0436

    Type: Mailing

  • 9286 S 2700 W

    WEST JORDAN, UT 840888620

    Phone: (801) 518-5116

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 102 Open Payments records for all available years, with a total value of $2,672.

Total Amount is formed as General ($2,672) + Research ($0) + Ownership ($0) = $2,672.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($683).

Total Amount

$2,672

General + Research + Ownership

Payments

102

Total payment records

General Amount

$2,672

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

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: 2022-02-17

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
I20220217001006IPhysician AssistantUTTBD

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
17003Destruction of precancer skin growth, 2-14 growths1,818268$0
99213Established patient office or other outpatient visit, 20-29 minutes521402$0
17000Destruction of precancer skin growth, 1 growth366312$0
99214Established patient office or other outpatient visit, 30-39 minutes182139$0
11102Biopsy of related skin growth, first growth155139$0
View full utilization report →

Insurance plans in this area (ZIP 13066)

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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: 0042573438View full group profile
NameSpecialtyState
Nurse PractitionerCO
Dermatology, Micrographic Dermatologic Surgery (Mds)NV

Reviews

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Frequently asked questions

Can I verify MICHAEL NATHEN WARREN (MPAS, PA-C) with an NPI only?
You can start verification with NPI 1114329810 for MICHAEL NATHEN WARREN (MPAS, PA-C), then check state licensing separately.
Is MICHAEL NATHEN WARREN (MPAS, PA-C) listed as active for patients and plans?
The listing shows MICHAEL NATHEN WARREN (MPAS, PA-C) as active in the NPI system.
What is MICHAEL NATHEN WARREN (MPAS, PA-C) best known for clinically?
Directory data describes MICHAEL NATHEN WARREN (MPAS, PA-C) with Physician Assistant. Clinical services aligned with this taxonomy classification.
Does MICHAEL NATHEN WARREN (MPAS, PA-C) list a practice location?
Patients near Fayetteville, New York may find MICHAEL NATHEN WARREN (MPAS, PA-C) in results; validate coverage separately.
Why does MICHAEL NATHEN WARREN (MPAS, PA-C) have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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