| Kristin Marie Balthazor, PA-C, MPAS | |
|
2124 Kohler Memorial Dr, Sheboygan, WI 53081-3169 | |
| (833) 821-7246 | |
| Not Available |
| Full Name | Kristin Marie Balthazor |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 20 Years |
| Location | 2124 Kohler Memorial Dr, Sheboygan, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649422619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 085.003246 (Illinois) | Secondary |
| 363A00000X | Physician Assistant | 4402-23 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Aurora Medical Ctr Manitowoc County | Two rivers, WI | Hospital |
| St Nicholas Hospital | Sheboygan, WI | Hospital |
| Aurora Medical Center Sheboygan County | Sheboygan, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wisconsin Spine And Pain Sc | 0345665469 | 19 |
| Entity Name | Wisconsin Spine and Pain SC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790309276 PECOS PAC ID: 0345665469 Enrollment ID: O20200806002745 |
| Mailing Address | Practice Location Address |
|---|---|
| Kristin Marie Balthazor, PA-C, MPAS 3624 County Road I, Saukville, WI 53080-1446 Ph: (630) 640-3057 | Kristin Marie Balthazor, PA-C, MPAS 2124 Kohler Memorial Dr, Sheboygan, WI 53081-3169 Ph: (833) 821-7246 |
Luke Elliot Stanczyk, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3400 Union Ave, Sheboygan, WI 53081 Phone: 920-828-2530 |
Marlee Anne Hall, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2414 Kohler Memorial Dr, Sheboygan, WI 53081 Phone: 920-457-4461 |
Blake C Schanen, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 3400 Union Ave, Sheboygan, WI 53081 Phone: 920-802-2100 |
Mary Fitzgerald Lovelien, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1703 N Taylor Dr, Sheboygan, WI 53081 Phone: 920-457-4438 |
Emily M Copps, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2414 Kohler Memorial Dr, Sheboygan, WI 53081 Phone: 920-457-4461 Fax: 920-459-1483 |
Erin Jennifer Leroy, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3400 Union Ave, Sheboygan, WI 53081 Phone: 920-802-2100 |
Kaitlin M Nawa, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 3400 Union Ave, Sheboygan, WI 53081 Phone: 920-802-1935 |