Active NPI
Kaitlyn Rae Wirtz, PA-C
- Physician Assistant
- Washburn, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1177 Border LN
Washburn, ND 58577-4102 - Phone
- (701) 462-3396
- Fax
- (701) 463-3422
- NPI assigned
- Jun 11, 2019
- Last updated
- Jun 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | ND | Primary |
Addresses
Primary practice location
1177 Border LN
Washburn, ND 58577-4102
Mailing address
PO Box 280
Turtle Lake, ND 58575-0280
Phone (701) 448-2331
Other practice location 1
220 5th Ave W
Turtle Lake, ND 58575-4324
Phone (701) 448-2334
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Alexius Medical Center
Practice addresses (Care Compare)
1177 Border LN
Washburn, ND 58577-4102
Phone (701) 462-3396
220 5TH Ave W
Turtle Lake, ND 58575-4324
Phone (701) 448-2331
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.48 of 100
- Quality
- 73.03
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.91
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Alexius Medical Center | Current | Accepting new patients | |
| St Alexius Medical Center | Current | Accepting new patients | |
| St. Alexius Medical Center | Current | Accepting new patients | |
| Garrison Memorial Hospital | Current | Accepting new patients | |
| Community Memorial Hospital | Past | Accepting new patients |
Locations
900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300
437 3rd Ave SE
Garrison, ND 58540
Phone (701) 463-2245
220 5th Ave W
Turtle Lake, ND 58575
Phone (701) 448-2331
1177 Border Ln
Washburn, ND 58577
Phone (701) 462-3396
Interoperability endpoints
- kwirtz506068@achce.catholichealth.net
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.
-
dba Garrison Family Clinic
- Rural Health Clinic/Center
- Garrison, ND
- NPI 1952381873
-
dba CHI St. Alexius Health Turtle Lake
- Critical Access Hospital
- Turtle Lake, ND
- NPI 1013961820
-
dba CHI St. Alexius Health Clinics
- Specialist
- Bismarck, ND
- NPI 1205868429
-
dba CHI St. Alexius Health
- Home Infusion Therapy Pharmacy
- Bismarck, ND
- NPI 1063663607
-
- Internal Medicine Physician
- Hamilton, NY
- NPI 1932100393
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba CHI St. Alexius Health Turtle Lake
- Critical Access Hospital
- Turtle Lake, ND
- NPI 1013961820
-
dba CHI St. Alexius Health
- General Acute Care Hospital
- Bismarck, ND
- NPI 1306832654
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1649839846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 280",
"city": "TURTLE LAKE",
"state": "ND",
"postal_code": "585750280",
"telephone_number": "701-448-2331",
"fax_number": "701-448-2441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1177 BORDER LN",
"city": "WASHBURN",
"state": "ND",
"postal_code": "585774102",
"telephone_number": "701-462-3396",
"fax_number": "701-463-3422"
}
],
"practiceLocations": [
{
"address_1": "220 5th Ave W",
"address_purpose": "LOCATION",
"city": "Turtle Lake",
"state": "ND",
"postal_code": "585754324",
"country_code": "US",
"telephone_number": "701-448-2334",
"fax_number": "701-448-2441",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WIRTZ",
"first_name": "KAITLYN",
"middle_name": "RAE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-11",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ND",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Washburn, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.