Individual provider Active NPI

Bryan N Wogen, PA-C

  • Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1588061725
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0004177 Issued in CO
Practice address
7610 N Union Blvd Ste 150
Colorado Springs, CO 80920-3800
Phone
(719) 434-8810
NPI assigned
Dec 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0004177 CO Primary

Addresses

Primary practice location

7610 N Union Blvd Ste 150
Colorado Springs, CO 80920-3800

Mailing address

559 Vincent St
Space Base Delta 1
Peterson Space Force Base, CO 80914
Phone (719) 922-0005

Other identifiers 1

IdentifierTypeStateIssuer
40533824MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150306000839 CO Practitioner - Physician Assistant 4284950403 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lykos Medical LLCGroup PAC ID 0941558035, 19 clinicians
MWS Wound Solutions LLCGroup PAC ID 2567801541, 5 clinicians

Practice addresses (Care Compare)

595 Chapel Hills Dr
Suite 303
Colorado Springs, CO 80920-1057
Phone (719) 434-8810

595 Chapel Hills Dr
Suite 303B
Colorado Springs, CO 80920-1022
Phone (719) 922-1002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0004177COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Flatirons Family Practice Inc PastSince Jan 9, 2011 Accepting new patients
Simms Crossing Family Practice Inc PastSince Jul 30, 2013 Accepting new patients
Rocky Mountain Senior Care SC PC Past Accepting new patients
Elane Shirar MD Inc PastSince Nov 1, 1999 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bryan.wogen.1@26269.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1588061725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST",
            "address_2": "SPACE BASE DELTA 1",
            "city": "PETERSON SPACE FORCE BASE",
            "state": "CO",
            "postal_code": "80914",
            "telephone_number": "719-922-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7610 N UNION BLVD STE 150",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203800",
            "telephone_number": "719-434-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOGEN",
        "first_name": "BRYAN",
        "middle_name": "N",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-03",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40533824",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.