BRANT MICHAEL BALTHAZOR MS, PA-C
NPI 1548640774
Physician Assistant in Sheboygan, WI

Active since June 03, 2015PECOS EnrolledAccepts Medicare Assignment
2124 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081(883) 821-7246 Get Directions Write a Review

NPPES record last updated: January 7, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 7, 2024, Nov 22, 2021, Sep 24, 2021 and 3 more (6 updates tracked since 2018).

About Brant Michael Balthazor Ms, Pa-c NPPES

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

BRANT MICHAEL BALTHAZOR MS, PA-C (NPI 1548640774) is an individual physician assistant in Sheboygan, Wisconsin, licensed in Wisconsin (4424-023) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS, is affiliated with Aurora Medical Ctr Manitowoc County, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1548640774
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameBRANT MICHAEL BALTHAZORCredential: MS, PA-C
Location Address2124 KOHLER MEMORIAL DRSheboygan, WI 53081-3169
Mailing Address3624 County Road ISaukville, WI 53080-1446 · (734) 945-3484
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateJune 3, 2015
Last NPPES UpdateJanuary 7, 20246 updates tracked since enumeration
NPPES CertifiedJanuary 7, 2024
NPI 1548640774 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses Licensed in WI · 4424-023 Licensed in IL · 085005469
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.
2124 KOHLER MEMORIAL DR, Sheboygan, WI 53081

Other Identifiers 1

Medicaid100100767WI

Accepted 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

Brant Michael Balthazor Ms, 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 ID5496063208
PECOS Enrollment IDI20200701001722
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 5

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.
498 services259 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.
218 services150 patients
Testing for presence of drug, by chemistry analyzers 80307
Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.
191 services144 patients
Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician 62370
This procedure involves a physician checking and adjusting your spinal canal drug infusion pump. The pump's programming is updated electronically and the medication reservoir is refilled, ensuring effective pain management and optimal device performance.
53 services23 patients
Ultrasonic guidance for needle placement 76942
Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.
48 services23 patients

Hospital Affiliations CMS Care Compare 3

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

Aurora Medical Ctr Manitowoc County

Acute Care Hospitals · Two Rivers, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number520034
Location5000 Memorial DriveTwo Rivers, WI 54241 · Manitowoc County
Emergency services Birthing friendly

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

St Nicholas Hospital

Acute Care Hospitals · Sheboygan, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520044
Location3100 Superior 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
$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 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Ambulatory Surgical)
2124 KOHLER MEMORIAL DR, STE 100
SHEBOYGAN, WI 53081
Specialist
2124 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081
Physician Assistant
2124 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081
Durable Medical Equipment & Medical Supplies
2124 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081
Durable Medical Equipment & Medical Supplies
2124 KOHLER MEMORIAL DR, SUITE 100
SHEBOYGAN, WI 53081
Clinic/Center (Ambulatory Surgical)
2124 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081

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 Brant Balthazor's NPI number?

The NPI number for Brant Balthazor is 1548640774. It was assigned to this individual provider in the NPPES registry on June 3, 2015.

Where is Brant Balthazor located?

Brant Balthazor practices at 2124 Kohler Memorial Dr, Sheboygan, WI 53081. The listed phone number is (883) 821-7246.

What is Brant Balthazor's specialty?

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

Is Brant Balthazor enrolled in Medicare?

Yes. Brant Balthazor is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Brant Balthazor accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Security Health Plan and UnitedHealthcare list Brant Balthazor as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Brant Balthazor affiliated with any hospitals?

According to CMS data, Brant Balthazor is affiliated with Aurora Medical Ctr Manitowoc County, Aurora Health Care Central Inc and St Nicholas Hospital.

When was this NPI record last updated?

The NPPES record for Brant Balthazor was last updated on January 7, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.