HEBA KALAJI MD
NPI 1053949339
Family Medicine in Sheboygan, WI

Q: What is Heba Kalaji's NPI number?

The NPI number for Heba Kalaji is 1053949339. It was assigned to this individual provider in the NPPES registry on March 31, 2020.

Q: What is Heba Kalaji's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Heba Kalaji was last updated on August 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 March 31, 2020PECOS EnrolledAccepts Medicare Assignment

2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081(920) 457-4461 Get Directions Write a Review

NPPES record last updated: August 16, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 16, 2023, Aug 9, 2023, Mar 31, 2020 (3 updates tracked since 2020).

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About Heba Kalaji Md NPPES

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

HEBA KALAJI MD (NPI 1053949339) is an individual family medicine provider in Sheboygan, Wisconsin, licensed in Wisconsin (81566) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS, is affiliated with Aurora Health Care Central Inc, and maintains a secondary practice location in Cleveland.

NPPES Registry Identity

NPI1053949339

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameHEBA KALAJICredential: MD

Location Address2414 KOHLER MEMORIAL DRSheboygan, WI 53081-3129

Mailing AddressPo Box 735044Chicago, IL 60673-5044

Phone(920) 457-4461

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateMarch 31, 2020

Last NPPES UpdateAugust 16, 20233 updates tracked since enumeration

NPPES CertifiedAugust 16, 2023

✔ NPI 1053949339 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WI · 81566

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2414 KOHLER MEMORIAL DR, Sheboygan, WI 53081

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Secondary Practice Location 1

Location 111100 Euclid AveCleveland, OH 44106-1716 · Phone (216) 844-1000

Other Identifiers 1

Medicaid100242128WI

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 and accepts Medicare assignment

Heba Kalaji Md 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 ID5799107579

PECOS Enrollment IDI20230712001620

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 6

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 low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

96 services65 patients

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.

66 services46 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.

45 services45 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

13 services12 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

12 services12 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.

12 services12 patients

Hospital Affiliations CMS Care Compare

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

Aurora Health Care Central Inc

Acute Care Hospitals · Sheboygan, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520035

Location3400 Union AveSheboygan, WI 53081 · Sheboygan County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53081 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

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

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.

LAURA J MARKHAM PT

Physical Therapist