NELLA WENNBERG (PA-C) – Surgical Physician Assistant, NPI 1144310673

NELLA WENNBERG (PA-C) is a healthcare provider. based in Waterbury center, Vermont. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 055-0030573 (VT). The NPI Number for NELLA WENNBERG (PA-C) is 1144310673

Main info

Female
Sole Proprietor
31 Years Of Experience
Accepts Medicare Assignment
Name
NELLA WENNBERG (PA-C)
NPI
1144310673
Phone
Not provided
Address
297 RUBY RAYMOND RD
Enumeration Date
13 October 2006
Last Update Date
23 July 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1995 (31 years ago)
PAC ID
0547250672
Group Practice PAC ID
9234125766
Professional Enrollment ID
I20040512001175
Address ID
VT056618973MO528XXHWYX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

385 PHYSICIAN ASSISTANT in VT

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Provider Addresses for NELLA WENNBERG (PA-C)

  • 297 RUBY RAYMOND RD

    WATERBURY CENTER, VT 056778087

    Phone:

    Type: Mailing

  • 555, Washington Highway, Morrisville, Morristown, Lamoille County, Vermont, 05661, United States

    MORRISVILLE, VT 056618972

    Phone: (802) 888-8405

    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: 2004-05-12

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
I20040512001175IPhysician 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 05677)

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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: 9234125766View full group profile
NameSpecialtyState
Physician AssistantVT
Orthopedic SurgeryVT
General SurgeryNH
-VT
Physical Therapist In Private PracticeVT
Orthopedic SurgerySC
Emergency MedicineAK
Orthopedic SurgeryVT
O B S T E T R I C S/ G Y N E C O L O G YVT
Emergency MedicineAK

Reviews

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Frequently asked questions

What is the registry number for NELLA WENNBERG (PA-C)?
The registry entry for NELLA WENNBERG (PA-C) shows NPI 1144310673.
Is NELLA WENNBERG (PA-C)'s NPI status active today?
Active status means NELLA WENNBERG (PA-C)'s NPI record is not deactivated in the public file.
How should patients interpret NELLA WENNBERG (PA-C)'s specialty?
The extract shows Surgical Physician Assistant for NELLA WENNBERG (PA-C). Clinical services aligned with this taxonomy classification.
What geographic area is tied to NELLA WENNBERG (PA-C)?
NELLA WENNBERG (PA-C) is associated with Waterbury Center, Vermont in the same public data insurers reference.
Who maintains NELLA WENNBERG (PA-C)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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