MRS. PAULA LYNN PENGILLY (FNP) – Family Nurse Practitioner, NPI 1306839865
Family Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MRS. PAULA LYNN PENGILLY (FNP)
PO BOX 460
RAWLINS, WY 823010460
Phone: (307) 324-2221
Fax: (307) 324-8371
Type: Mailing
17807 US HWY 59 NE
ROSE MEDICAL MANAGEMENT
THIEF RIVER FALLS, MN 567015670
Phone: (361) 413-5179
Type: Location
42, Dallas Hill Road, Rangeley, Franklin County, Maine, 04970, United States
RANGELEY, ME 049704032
Phone: (207) 864-3303
Fax: (207) 864-2969
Type: Location
100 County Road B
Shawano, WI 541667072
Phone: (715) 524-2161
Type: Location
42 Dallas Hill Rd
Rangeley, ME 049704032
Phone: (207) 864-3303
Fax: (207) 864-2969
Type: Location
3461 37TH ST NE
INKSTER, ND 582339306
Phone:
Type: Mailing
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: 2018-07-06
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180706000212 | I | Nurse Practitioner | WI | 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 82301)
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