KRYSTAL A MITICH PA-C
NPI 1407209828
Physician Assistant in Green Bay, WI

Q: What is Krystal Mitich's NPI number?

The NPI number for Krystal Mitich is 1407209828. It was assigned to this individual provider in the NPPES registry on July 20, 2016.

Q: What is Krystal Mitich'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 Krystal Mitich was last updated on February 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 20, 2016PECOS EnrolledAccepts Medicare Assignment

1821 S WEBSTER AVE, GREEN BAY, WI 54301(920) 496-4700 Get Directions Write a Review

NPPES record last updated: February 10, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 10, 2023, Nov 15, 2022, Jan 10, 2022 and 2 more (5 updates tracked since 2018).

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About Krystal A Mitich Pa-c NPPES

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

KRYSTAL A MITICH PA-C (NPI 1407209828) is an individual physician assistant in Green Bay, Wisconsin, licensed in Wisconsin (4248-23) and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS, is affiliated with Bellin Memorial Hospital, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1407209828

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKRYSTAL A MITICHCredential: PA-C

Location Address1821 S WEBSTER AVEGreen Bay, WI 54301-2253

Mailing Address1821 S Webster AveGreen Bay, WI 54301-2253 · (920) 496-4700

Phone(920) 496-4700

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateJuly 20, 2016

Last NPPES UpdateFebruary 10, 20235 updates tracked since enumeration

NPPES CertifiedDecember 28, 2022

✔ NPI 1407209828 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 · 4248-23

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.

1821 S WEBSTER AVE, Green Bay, WI 54301

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health.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

Krystal A Mitich 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 ID9537432703

PECOS Enrollment IDI20180122001506

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.

Hospital Affiliations CMS Care Compare 2

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

Bellin Memorial Hospital

Acute Care Hospitals · Green Bay, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520049

Location744 S Webster AveGreen Bay, WI 54305 · Brown County

Emergency services Birthing friendly

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number520075

Location835 S Van Buren StGreen Bay, WI 54301 · Brown County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54301 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.

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