Individual provider Active NPI

Robert E Kollpainter, PA-C

  • Surgical Physician Assistant
  • Wausau, WI
National Provider Identifier
1144249210
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
981 Issued in WI
Practice address
425 Pine Ridge Blvd
Suite 209
Wausau, WI 54401
Phone
(715) 847-0400
Fax
(715) 847-0401
NPI assigned
Jul 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 981 WI Primary

Addresses

Primary practice location

425 Pine Ridge Blvd
Suite 209
Wausau, WI 54401

Mailing address

425 Pine Ridge Blvd
Suite 209
Wausau, WI 54401
Phone (715) 847-0400

Other identifiers 1

IdentifierTypeStateIssuer
42970700MedicaidWI

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
I20080201000522 WI Practitioner - Physician Assistant 9739261454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
77.62
Promoting interoperability
100
Improvement activities
40
Cost
78.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
981WIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Medford Hospital & Clinics, Inc. CurrentSince Jul 1, 2011 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Jul 1, 2011 Accepting new patients
Aspirus Specialist Inc. Past Accepting new patients
Aspirus Specialists, Inc. Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

425 Pine Ridge Blvd
Ste 209
Wausau, WI 54401
Phone (715) 845-4606

425 Wind Ridge Dr
Wausau, WI 54401
Phone (715) 675-3391

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

4005 Community Center Dr
Ste 203
Weston, WI 54476
Phone (715) 241-5470

Organizations & group practices 5

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144249210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD",
            "address_2": "SUITE 209",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "54401",
            "telephone_number": "715-847-0400",
            "fax_number": "715-847-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD",
            "address_2": "SUITE 209",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "54401",
            "telephone_number": "715-847-0400",
            "fax_number": "715-847-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLPAINTER",
        "first_name": "ROBERT",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42970700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.