Kathy Ann Gates, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Clear Lake, Wisconsin. Her current practice location is
370 3rd Avenue, Clear Lake, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(715) 554-4224.
Kathy Ann Gates is licensed to practice in Wisconsin (license number 13578-33) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1356040612.
Provider's Profile
| Full Name | Kathy Ann Gates |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 370 3rd Avenue, Clear Lake, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1356040612
- Provider Enumeration Date: 02/27/2023
- Last Update Date: 07/03/2025
Medicare PECOS Information:
- PECOS PAC ID: 1557727039
- Enrollment ID: I20230525003166
Medical Identifiers
Medical identifiers for Kathy Ann Gates such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1356040612 | NPI | - | NPPES |
| 13578-33 | Other | WI | RN LICENSE # |
| 249808-30 | Other | WI | APRN LICENSE # |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LF0000X | Nurse Practitioner - Family | 13578-33 (Wisconsin) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kathy Ann Gates allows following entities to bill medicare on her behalf.
| Entity Name | Baldwin Area Medical Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1467496133
PECOS PAC ID: 7911800586
Enrollment ID: O20040310000505 |
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| Entity Name | St Croix Valley Shared Services Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1578774014
PECOS PAC ID: 0244211258
Enrollment ID: O20210510001789 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kathy Ann Gates is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kathy Ann Gates, FNP-C
Po Box 133,
Clear Lake, WI 54005-0133
Ph: (715) 554-4224 | Kathy Ann Gates, FNP-C
370 3rd Avenue,
Clear Lake, WI 54005-9658
Ph: (715) 554-4224 |
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