Individual provider Active NPI

Mark Byaliy, PA-C

  • Physician Assistant
  • Mount Pleasant, WI
National Provider Identifier
1083155063
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5439 Durand Ave Ste 100
Mount Pleasant, WI 53406-5058
Phone
(262) 898-9000
NPI assigned
Mar 10, 2017
Last updated
Oct 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X WI Primary
Athletic Trainer 2255A2300X NU

Addresses

Primary practice location

5439 Durand Ave Ste 100
Mount Pleasant, WI 53406-5058

Mailing address

5439 Durand Ave Ste 100
Mount Pleasant, WI 53406-5058

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
I20260211002147 WI Practitioner - Physician Assistant 3971082728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BSH, SCGroup PAC ID 4082996954, 9 clinicians

Practice addresses (Care Compare)

5439 Durand Ave
Suite 100
Mount Pleasant, WI 53406-5058
Phone (262) 898-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
BSH, SC CurrentSince Oct 28, 2025 Accepting new patients

Locations

5439 Durand Ave
Ste 100
Mount Pleasant, WI 53406
Phone (262) 898-9000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBAGDD/Endpoint/BBAGDD

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1083155063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5439 DURAND AVE STE 100",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5439 DURAND AVE STE 100",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065058",
            "telephone_number": "262-898-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYALIY",
        "first_name": "MARK",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-10",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

Verify at the official NPI Registry.