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NICHOLAS PETER WANNER PA-C
NPI 1124564240
Physician Assistant in Eagan, MN

Active since January 12, 2017PECOS EnrolledAccepts Medicare Assignment
1885 PLAZA DR, EAGAN, MN 55122(952) 993-4001 Get Directions Write a Review

NPPES record last updated: August 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 15, 2025, Jan 12, 2017 (2 updates tracked since 2017).

About Nicholas Peter Wanner Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICHOLAS PETER WANNER PA-C (NPI 1124564240) is an individual physician assistant in Eagan, Minnesota, licensed in Minnesota (12349) and active in the NPI registry since January 2017. He is enrolled in Medicare PECOS, is affiliated with Park Nicollet Methodist Hospital, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1124564240
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameNICHOLAS PETER WANNERCredential: PA-C
Location Address1885 PLAZA DREagan, MN 55122-2979
Mailing Address1885 Plaza DrEagan, MN 55122-2979 · (952) 993-4001
Phone(952) 993-4001
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJanuary 12, 2017
Last NPPES UpdateAugust 15, 20252 updates tracked since enumeration
NPPES CertifiedAugust 15, 2025
✔ NPI 1124564240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MN · 12349
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X
1885 PLAZA DR, Eagan, MN 55122
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicholas Peter Wanner Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9032492970
PECOS Enrollment IDI20170220001288
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
266 services168 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
224 services144 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
121 services121 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
91 services70 patients
Telephone medical discussion with physician, 21-30 minutes 99443
This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.
27 services23 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
14 services14 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Park Nicollet Methodist Hospital

Acute Care Hospitals · Saint Louis Park, MN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240053
Location6500 Excelsior BlvdSaint Louis Park, MN 55426 · Hennepin County
Emergency services Birthing friendly

Lakeview Memorial Hospital

Acute Care Hospitals · Stillwater, MN
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number240066
Location927 West Churchill StreetStillwater, MN 55082 · Washington County
Emergency services Birthing friendly

Regions Hospital

Acute Care Hospitals · Saint Paul, MN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240106
Location640 Jackson StreetSaint Paul, MN 55101 · Ramsey County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55122 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers11 claims11 services$183.93 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JEFFREY JOHN MOHR PA-C
Physician Assistant (Medical)
1885 PLAZA DR
EAGAN, MN 55122
Dakota County (952) 993-4001
ROSA GREBIN AGNP-C
Nurse Practitioner
1885 PLAZA DR
EAGAN, MN 55122
Dakota County (952) 993-4001
JORI L SHORE
Nurse Practitioner (Family)
1885 PLAZA DR, PARK NICOLLET CLINIC - EAGAN
EAGAN, MN 55122
Dakota County (952) 993-4001
MARY ALIVIA TOLSMA PA
Physician Assistant
1885 PLAZA DR
EAGAN, MN 55122
Dakota County (952) 993-4001
CLARE LOUISE MACDONALD-SEXTON LICSW
Social Worker (Clinical)
1885 PLAZA DR
EAGAN, MN 55122
Dakota County (952) 993-4001
JOHN P EDWARDS
Obstetrics & Gynecology
1885 PLAZA DR
EAGAN, MN 55122
Dakota County (952) 993-4001
MS. ELLEN A CONNOLLY-ECKHOFF CPNP
Nurse Practitioner (Pediatrics)
1885 PLAZA DR
EAGAN, MN 55122
Dakota County (952) 993-4001
TASHA GASTONY PAC
Physician Assistant
1885 PLAZA DR
EAGAN, MN 55122
Dakota County (952) 993-4001

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicholas Wanner's NPI number?

The NPI number for Nicholas Wanner is 1124564240. It was assigned to this individual provider in the NPPES registry on January 12, 2017.

Where is Nicholas Wanner located?

Nicholas Wanner practices at 1885 Plaza Dr, Eagan, MN 55122. The listed phone number is (952) 993-4001.

What is Nicholas Wanner's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Nicholas Wanner enrolled in Medicare?

Yes. Nicholas Wanner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Nicholas Wanner accept?

Health plans from HealthPartners and Medica list Nicholas Wanner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Nicholas Wanner affiliated with any hospitals?

According to CMS data, Nicholas Wanner is affiliated with Park Nicollet Methodist Hospital, Lakeview Memorial Hospital and Regions Hospital.

When was this NPI record last updated?

The NPPES record for Nicholas Wanner was last updated on August 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.