Individual provider Active NPI

Krista M Solarek, PA-C

  • Physician Assistant
  • Green Bay, WI
National Provider Identifier
1003298043
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
355423 Issued in WI
Practice address
1970 S Ridge Rd
Green Bay, WI 54304-4125
Phone
(920) 430-4888
Fax
(920) 430-4889
NPI assigned
Jun 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 355423 WI Primary

Addresses

Primary practice location

1970 S Ridge Rd
Green Bay, WI 54304-4125

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222

Other practice location 1

191 Memorial Dr
Berlin, WI 54923-1241
Phone (920) 361-4239

Other identifiers 1

IdentifierTypeStateIssuer
1126340OtherNATIONAL COMMISSION ON CERTIFIED PHYSICIANS ASSISTANTS

Other names 1

  • Mrs. Krista Kasuboski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150827002752 WI Practitioner - Physician Assistant 2062728611 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Wisconsin School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oconto Hospital and Medical Center IncGroup PAC ID 2163461781, 217 clinicians
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

107 E Highland Dr
Oconto Falls, WI 54154-1002
Phone (920) 846-3092

1970 S Ridge Rd
Green Bay, WI 54304-4125
Phone (920) 430-4888

2020 S Webster Ave
Accounting
Green Bay, WI 54301-3505

744 S Webster Ave
Green Bay, WI 54301-3505

933 Waube LN
Green Bay, WI 54304-5521
Phone (920) 548-9500

Hospital & facility affiliations

  • Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
355423WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Oconto Hospital & Medical Center, Inc. CurrentSince Jul 26, 2021 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Jul 24, 2020 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Jul 26, 2021 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Jul 24, 2020 Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

831 Parker Ave
Algoma, WI 54201
Phone (920) 487-3084

933 Waube Ln
Green Bay, WI 54304
Phone (920) 548-9500

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

575 4th St
Kewaunee, WI 54216
Phone (920) 388-4640

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Interoperability endpoints

  • Direct secure messaging: ksolarek924901@direct.emplifyhealth.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1003298043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 S RIDGE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044125",
            "telephone_number": "920-430-4888",
            "fax_number": "920-430-4889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "191 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "WI",
            "postal_code": "549231241",
            "country_code": "US",
            "telephone_number": "920-361-4239",
            "fax_number": "920-361-6542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLAREK",
        "first_name": "KRISTA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "355423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL COMMISSION ON CERTIFIED PHYSICIANS ASSISTANTS",
            "identifier": "1126340",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTA",
            "last_name": "KASUBOSKI",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.