Kirsten D Pethan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5206 Issued in WI

Practice address

145 W Calumet St
Appleton, WI 54915-4934

Phone

(920) 967-4141

Fax

(833) 972-1585

NPI assigned

Aug 1, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

94.81 of 100Reported as apm

Quality

85.98

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kirsten.pethan.1@31026.direct.athenahealth.com
• Direct secure messaging: kpethan299925@direct.thedacare.org

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1033465679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 W CALUMET ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549154934",
            "fax_number": "833-972-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 W CALUMET ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549154934",
            "telephone_number": "920-967-4141",
            "fax_number": "833-972-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETHAN",
        "first_name": "KIRSTEN",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-01",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "5206",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen M Peterson, NP
• Lowell Frank Peterson, MD
• Neal Michael Peterson, CRNA
• Richard Peterson
• Sarah Elizabeth Peterson, APSW
• Kristen Anne Pethan, CPM
• Korah Lee Petrasko, LPC
• Laurie J Petrie-Kampa, OTR, CHT
• Mikayla Ruth Petzke, NP
• Michelle A Pevonka-Thompson, BSN, RN

• Physician Assistant in Appleton, WI
• Providers in Appleton, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.