MR. WARREN M FENNER (PA-C) – Physician Assistant, NPI 1063850915

MR. WARREN M FENNER (PA-C) is a healthcare provider. based in Springfield, Vermont. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 055-0031215 (VT). The NPI Number for MR. WARREN M FENNER (PA-C) is 1063850915

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
MR. WARREN M FENNER (PA-C)
NPI
1063850915
Phone
Not provided
Address
25 RIDGEWOOD RD
Enumeration Date
12 June 2013
Last Update Date
12 August 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8027287000
Graduation Year
2012 (14 years ago)
PAC ID
6901048503
Group Practice PAC ID
4880683663
Professional Enrollment ID
I20141006002357
Address ID
VT050601381RA44XXXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

385 PHYSICIAN ASSISTANT in VT

Provider Addresses for MR. WARREN M FENNER (PA-C)

  • 25 RIDGEWOOD RD

    EMERGENCY DEPARTMENT

    SPRINGFIELD, VT 051563050

    Phone:

    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)

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: 2014-10-06

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
I20141006002357IPhysician AssistantVTTBD

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 05156)

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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: 4880683663View full group profile
NameSpecialtyState
Emergency MedicineVT
-VT
Physician AssistantVT
General SurgeryVA
H O S P I T A L I S TFL
Diagnostic RadiologyIL
Family PracticeVT
O B S T E T R I C S/ G Y N E C O L O G YCA
Family PracticeNH
Nurse PractitionerVT

Reviews

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Frequently asked questions

Where can patients find MR. WARREN M FENNER (PA-C)'s NPI?
You can confirm MR. WARREN M FENNER (PA-C) with NPI 1063850915; it appears in the national provider directory.
Is MR. WARREN M FENNER (PA-C) active in the national directory?
MR. WARREN M FENNER (PA-C)'s public NPI profile is in an active state.
What kind of provider is MR. WARREN M FENNER (PA-C)?
The page reflects Physician Assistant for MR. WARREN M FENNER (PA-C). Clinical services aligned with this taxonomy classification.
What location metadata exists for MR. WARREN M FENNER (PA-C)?
The page summarizes Springfield, Vermont for MR. WARREN M FENNER (PA-C); expand the address list for detail.
How can I contact MR. WARREN M FENNER (PA-C)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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