ALICIA BARKHOLTZ
NPI 1407575004
Nurse Practitioner - Family in Fond Du Lac, WI
About Alicia Barkholtz NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ALICIA BARKHOLTZ (NPI 1407575004) is an individual family provider in Fond Du Lac, Wisconsin, licensed in Wisconsin (F06222127) and active in the NPI registry since August 2022. She has opted out of Medicare through July 9, 2028.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Alicia Barkholtz has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 9, 2024 through July 9, 2028.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Alicia Barkholtz's NPI number?
The NPI number for Alicia Barkholtz is 1407575004. It was assigned to this individual provider in the NPPES registry on August 25, 2022.
Where is Alicia Barkholtz located?
Alicia Barkholtz practices at 180 Knights Way, Fond Du Lac, WI 54935. The listed phone number is (920) 922-5433.
What is Alicia Barkholtz's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Alicia Barkholtz enrolled in Medicare?
No. Alicia Barkholtz has opted out of Medicare through July 9, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Alicia Barkholtz was last updated on August 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Alicia Barkholtz · NPI 1407575004
Family physician in Fond Du Lac, Wisconsin. Individual provider, active in the CMS NPPES registry since August 25, 2022.
## Identity
- **NPI:** 1407575004 (Entity type: Individual)
- **Enumerated:** August 25, 2022
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** F06222127 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 180 KNIGHTS WAY, Fond Du Lac, WI 54935-8027
- **Phone:** (920) 922-5433
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through July 9, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** August 25, 2022
---
Source: [NPI Profile](https://npiprofile.com/npi/1407575004) · Data from the CMS NPPES public registry.