Individual provider Active NPI

Catherine R. Valentyn, P.A. - C.

  • Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1578558045
Registry record updated Apr 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1750-023 Issued in WI
Practice address
633 E Mason St
Milwaukee, WI 53202-3813
Phone
(414) 665-8400
Fax
(414) 665-5730
NPI assigned
Sep 12, 2005
Last updated
Apr 10, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2017

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 1750-023 WI Primary

Addresses

Primary practice location

633 E Mason St
Milwaukee, WI 53202-3813

Mailing address

633 E Mason St
Milwaukee, WI 53202-3813
Phone (414) 665-8400

Other identifiers 1

IdentifierTypeStateIssuer
41989700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1750-023WIMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491782400000",
    "number": "1578558045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 E MASON ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023813",
            "telephone_number": "414-665-8400",
            "fax_number": "414-665-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 E MASON ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023813",
            "telephone_number": "414-665-8400",
            "fax_number": "414-665-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENTYN",
        "first_name": "CATHERINE",
        "middle_name": "R.",
        "credential": "P.A. - C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2017-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1750-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41989700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.