KELLY BAKER PAC
NPI 1043663818
Physician Assistant in Milwaukee, WI

Q: What is Kelly Baker's NPI number?

The NPI number for Kelly Baker is 1043663818. It was assigned to this individual provider in the NPPES registry on July 18, 2016. The provider is also known as Kelly Brock Pac.

Q: What is Kelly Baker's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kelly Baker was last updated on January 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.

Active since July 18, 2016PECOS Enrolled

9000 W WISCONSIN AVE, MILWAUKEE, WI 53226(414) 266-6457(414) 266-2294 Get Directions Write a Review

NPPES record last updated: January 15, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 15, 2021, Nov 25, 2020 (2 updates tracked since 2020).

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About Kelly Baker Pac NPPES

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

KELLY BAKER PAC (NPI 1043663818) is an individual physician assistant in Milwaukee, Wisconsin, licensed in Wisconsin (3828) and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS and maintains a secondary practice location in Milwaukee.

NPPES Registry Identity

NPI1043663818

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKELLY BAKERCredential: PAC

Location Address9000 W WISCONSIN AVEMilwaukee, WI 53226-4874

Mailing Address9000 W Wisconsin AveMilwaukee, WI 53226-4874 · (414) 266-6457 · Fax (414) 266-2294

Phone(414) 266-6457

Fax(414) 266-2294

Sole ProprietorNo

Enumeration DateJuly 18, 2016

Last NPPES UpdateJanuary 15, 20212 updates tracked since enumeration

NPPES CertifiedJanuary 15, 2021

✔ NPI 1043663818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in WI · 3828

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.

9000 W WISCONSIN AVE, Milwaukee, WI 53226

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Other Names 1

Former Name (1)Kelly Brock Pac

Secondary Practice Location 1

Location 12350 N Lake Dr, SUITE 206Milwaukee, WI 53211-4528 · Phone (414) 298-7280 · Fax (414) 298-7281

Other Identifiers 1

Medicaid1043663818WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Baker Pac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53226 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

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.

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.

MS. LESLIE L. TALBERT NP

Nurse Practitioner (Pediatrics)

9000 W WISCONSIN AVE, PEDIATRIC CRITICAL CARE
MILWAUKEE, WI 53226

Milwaukee County (414) 266-3360

SARAH MARIE RUMLER DO

Pediatrics (Pediatric Hematology-Oncology)