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KRISTIN MARIE BALTHAZOR PA-C, MPAS
NPI 1649422619
Physician Assistant in Sheboygan, WI

Active since October 21, 2008PECOS EnrolledAccepts Medicare Assignment
97.32/100
CMS Quality Rating
2124 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081(833) 821-7246 Get Directions Write a Review

NPPES record last updated: March 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 13, 2023, Sep 24, 2021, Jan 4, 2021 and 2 more (5 updates tracked since 2016).

About Kristin Marie Balthazor Pa-c, Mpas NPPES

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

KRISTIN MARIE BALTHAZOR PA-C, MPAS (NPI 1649422619) is an individual physician assistant in Sheboygan, Wisconsin, licensed in Wisconsin (4402-23) and active in the NPI registry since October 2008. She is enrolled in Medicare PECOS, is affiliated with Aurora Medical Ctr Manitowoc County, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1649422619
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKRISTIN MARIE BALTHAZORCredential: PA-C, MPAS
Location Address2124 KOHLER MEMORIAL DRSheboygan, WI 53081-3169
Mailing Address3624 County Road ISaukville, WI 53080-1446 · (630) 640-3057
Phone(833) 821-7246
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateOctober 21, 2008
Last NPPES UpdateMarch 13, 20235 updates tracked since enumeration
NPPES CertifiedMarch 13, 2023
✔ NPI 1649422619 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 · 4402-23✔ Licensed in IL · 085.003246
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
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Other Names 1

Former Name (1)Kristin Marie Wyer Pa-c, Mpas

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Security Health Plan 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

Kristin Marie Balthazor Pa-c, Mpas 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 ID345398921
PECOS Enrollment IDI20220201000452
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 3

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.
205 services99 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.
147 services85 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.
105 services71 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.

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.

97.32/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality88.78
Improvement Activities40

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.

SHEBOYGAN MEDICAL CENTER, LLC
Clinic/Center (Ambulatory Surgical)
2124 KOHLER MEMORIAL DR, STE 100
SHEBOYGAN, WI 53081
Sheboygan County (920) 452-7246
BRANT MICHAEL BALTHAZOR MS, PA-C
Physician Assistant
2124 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081
Sheboygan County (883) 821-7246
ADVANCED PAIN MANAGEMENT
Specialist
2124 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081
Sheboygan County (414) 325-3713
ADVANCED PAIN MANAGEMENT SC
Durable Medical Equipment & Medical Supplies
2124 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081
Sheboygan County (414) 325-7246
SHEBOYGAN MEDICAL CENTER, LLC
Durable Medical Equipment & Medical Supplies
2124 KOHLER MEMORIAL DR, SUITE 100
SHEBOYGAN, WI 53081
Sheboygan County (414) 325-7246
SPINE SOLUTIONS OF SHEBOYGAN LLC
Clinic/Center (Ambulatory Surgical)
2124 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081
Sheboygan County (414) 455-1153

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 Kristin Balthazor's NPI number?

The NPI number for Kristin Balthazor is 1649422619. It was assigned to this individual provider in the NPPES registry on October 21, 2008. The provider is also known as Kristin Marie Wyer Pa-C, Mpas.

Where is Kristin Balthazor located?

Kristin Balthazor practices at 2124 Kohler Memorial Dr, Sheboygan, WI 53081. The listed phone number is (833) 821-7246.

What is Kristin Balthazor's specialty?

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

Is Kristin Balthazor enrolled in Medicare?

Yes. Kristin 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 Kristin Balthazor accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Security Health Plan and UnitedHealthcare list Kristin 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 Kristin Balthazor affiliated with any hospitals?

According to CMS data, Kristin 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 Kristin Balthazor was last updated on March 13, 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.