CAROL BALLWEG APNP
NPI 1609990381
Nurse Practitioner - Family in Fitchburg, WI

Active since March 19, 2007PECOS EnrolledAccepts Medicare Assignment
80.22/100
CMS Quality Rating
3051 CAHILL MAIN, FITCHBURG, WI 53711(608) 661-7200 Get Directions Write a Review

NPPES record last updated: September 8, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Carol Ballweg Apnp NPPES

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

CAROL BALLWEG APNP (NPI 1609990381) is an individual family provider in Fitchburg, Wisconsin, licensed in Wisconsin (4542) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS, is affiliated with University Of Wi Hospitals & Clinics Authority, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1609990381
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameCAROL BALLWEGCredential: APNP
Location Address3051 CAHILL MAINFitchburg, WI 53711-7109
Mailing Address3051 Cahill MainFitchburg, WI 53711-7109 · (608) 661-7200
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateMarch 19, 2007
Last NPPES UpdateSeptember 8, 2011
NPI 1609990381 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in WI · 4542
Also ListedRegistered Nurse · Diabetes EducatorTaxonomy 163WD0400X · License 126927-030 (WI)
3051 CAHILL MAIN, Fitchburg, WI 53711

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

Carol Ballweg Apnp 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 ID3779756119
PECOS Enrollment IDI20111101000296
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 12

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.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
87 services54 patients
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.
60 services49 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.
39 services33 patients
Blood test, basic group of blood chemicals (calcium, total) 80048
A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.
37 services30 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
34 services24 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
33 services31 patients

Hospital Affiliations CMS Care Compare

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

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number520098
Location600 Highland AvenueMadison, WI 53792 · Dane County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53711 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

80.22/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85.06
Promoting Interoperability99
Improvement Activities40
Cost49.83

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.

Nurse Practitioner
3051 CAHILL MAIN
FITCHBURG, WI 53711
Family Medicine
3051 CAHILL MAIN
FITCHBURG, WI 53711
Nurse Practitioner
3051 CAHILL MAIN
FITCHBURG, WI 53711
Psychiatry & Neurology (Psychiatry)
3051 CAHILL MAIN
FITCHBURG, WI 53711
Optometrist
3051 CAHILL MAIN
FITCHBURG, WI 53711
Pharmacist
3051 CAHILL MAIN
FITCHBURG, WI 53711
Counselor (Mental Health)
3051 CAHILL MAIN
FITCHBURG, WI 53711
Genetic Counselor, MS
3051 CAHILL MAIN
FITCHBURG, WI 53711

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 Carol Ballweg's NPI number?

The NPI number for Carol Ballweg is 1609990381. It was assigned to this individual provider in the NPPES registry on March 19, 2007.

Where is Carol Ballweg located?

Carol Ballweg practices at 3051 Cahill Main, Fitchburg, WI 53711. The listed phone number is (608) 661-7200.

What is Carol Ballweg's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Carol Ballweg enrolled in Medicare?

Yes. Carol Ballweg 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 Carol Ballweg accept?

Health plans from Group Health Cooperative-SCW list Carol Ballweg 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 Carol Ballweg affiliated with any hospitals?

According to CMS data, Carol Ballweg is affiliated with University Of Wi Hospitals & Clinics Authority.

When was this NPI record last updated?

The NPPES record for Carol Ballweg was last updated on September 8, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.