DR. SKY WOLF – Military Health Care Provider, NPI 1174765093

DR. SKY WOLF is a healthcare provider. based in Cheyenne, Wyoming. specializing in FAMILY PRACTICE. They hold a License No. 12285A (WY). The NPI Number for DR. SKY WOLF is 1174765093

Main info

Female
18 Years Of Experience
Accepts Medicare Assignment
Name
DR. SKY WOLF
NPI
1174765093
Phone
(307) 773-2779
Address
6900 ALDEN DR BLDG 160
Enumeration Date
25 March 2009
Last Update Date
27 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8003535400
Graduation Year
2008 (18 years ago)
PAC ID
5193017101
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20231117002332
Address ID
CA933011407BA3733XSTXX401
Telehealth
Yes

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience77
Completeness85
Years active:17State licenses:2Other namesUpdated within 12 months

328 FAMILY PRACTICE in WY

Provider Addresses for DR. SKY WOLF

  • 6900 ALDEN DR BLDG 160

    CHEYENNE, WY 820052945

    Phone: (307) 773-2779

    Type: Location

  • 9500 Gilman Dr

    LA Jolla, CA 920930811

    Phone: (858) 534-9540

    Fax: (858) 534-9404

    Type: Location

  • 820 E 17th St

    Cheyenne, WY 820014714

    Phone: (307) 632-2434

    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: 2023-11-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20191206000630IFamily PracticeWYTBD
I20231117002332IFamily PracticeCATBD

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 82005)

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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: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
Physician AssistantCA
Emergency MedicineNC
O P H T H A L M O L O G YCA
Anesthesiology, Pain ManagementNH
Family Practice, Sports MedicineCA

Reviews

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Frequently asked questions

Is DR. SKY WOLF listed with a National Provider Identifier?
Yes — DR. SKY WOLF has NPI 1174765093 on file in the registry.
Is there an active status for DR. SKY WOLF?
For scheduling context, DR. SKY WOLF is shown as active in the registry.
How would a patient describe DR. SKY WOLF's focus?
For DR. SKY WOLF, the primary taxonomy reads as Military Health Care Provider. Clinical services aligned with this taxonomy classification.
Is DR. SKY WOLF located near Cheyenne?
DR. SKY WOLF currently maps to Cheyenne, Wyoming in this extract.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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