ANGELA WIDLER (PA) – Medical Physician Assistant, NPI 1457776049
Medical Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
496 PHYSICIAN ASSISTANT in ND
Provider Addresses for ANGELA WIDLER (PA)
PO BOX 7549
PORTSMOUTH, VA 237070549
Phone: (757) 686-3508
Fax: (757) 686-0541
Type: Mailing
307 1st Ave NW
Kenmare, ND 587467104
Phone: (701) 385-4283
Type: Location
2305 37th Ave SW
Minot, ND 587017669
Phone: (701) 418-8000
Type: Location
4092 FOXWOOD DR
VA BEACH, VA 234625225
Phone: (757) 686-3508
Fax: (757) 686-0541
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: 2024-07-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20161109000918 | I | Physician Assistant | CO | TBD |
| I20221017002628 | I | Physician Assistant | MT | TBD |
| I20231130002879 | I | Physician Assistant | ND | TBD |
| I20240729002432 | I | Physician Assistant | TX | TBD |
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.
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 23707)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CO | |
| Mental Health Counselor | SD | |
| Family Practice | CO | |
| Family Practice | FL | |
| Family Practice | CO | |
| - | ID | |
| Mental Health Counselor | CO | |
| Nurse Practitioner | WA | |
| - | CO | |
| Nurse Practitioner | NE |
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