Individual provider Active NPI

Holly Lynn Pautz, PA - C

  • Physician Assistant
  • Brillion, WI
National Provider Identifier
1699971978
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2141 Issued in WI
Practice address
964 W Ryan St
Suite B
Brillion, WI 54110-1076
Phone
(920) 756-2055
NPI assigned
Jun 25, 2007
Last updated
Mar 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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 2141 WI Primary

Addresses

Primary practice location

964 W Ryan St
Suite B
Brillion, WI 54110-1076

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210

Other practice location 1

555 Quality Ct
Wrightstown, WI 54180-9006
Phone (920) 532-6320

Other practice location 2

595 County Road R
Denmark, WI 54208-9120
Phone (920) 863-2005

Other practice location 3

723 S Wisconsin St
Pulaski, WI 54162-9303
Phone (920) 822-1100

Other practice location 4

405 Commercial St
Seymour, WI 54165-8474
Phone (920) 833-2318

Other practice location 5

2714 Riverview Dr
Green Bay, WI 54313-6715
Phone (920) 430-4760

Other practice location 6

441 French St
Peshtigo, WI 54157-1203
Phone (715) 582-9949

Other names 1

  • Holly L Vanzeeland Former name

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
I20070801000032 WI Practitioner - Physician Assistant 4981795291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

1630 Commanche Ave
Green Bay, WI 54313-5753
Phone (920) 430-4700

2020 S Webster Ave
Accounting
Green Bay, WI 54301-3505

405 Commercial St
Seymour, WI 54165-8474
Phone (920) 833-2318

555 Quality CT
Wrightstown, WI 54180-9006
Phone (920) 532-6320

744 S Webster Ave
Green Bay, WI 54301-3505

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Feb 2, 2015 Accepting new patients

Locations

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

405 Commercial St
Seymour, WI 54165
Phone (920) 833-2318

Interoperability endpoints

  • Direct secure messaging: hpautz32236@direct.thedacare.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1699971978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "964 W RYAN ST",
            "address_2": "SUITE B",
            "city": "BRILLION",
            "state": "WI",
            "postal_code": "541101076",
            "telephone_number": "920-756-2055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Quality Ct",
            "address_purpose": "LOCATION",
            "city": "Wrightstown",
            "state": "WI",
            "postal_code": "541809006",
            "country_code": "US",
            "telephone_number": "920-532-6320",
            "fax_number": "920-532-6269",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "595 County Road R",
            "address_purpose": "LOCATION",
            "city": "Denmark",
            "state": "WI",
            "postal_code": "542089120",
            "country_code": "US",
            "telephone_number": "920-863-2005",
            "fax_number": "920-863-6416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "723 S Wisconsin St",
            "address_purpose": "LOCATION",
            "city": "Pulaski",
            "state": "WI",
            "postal_code": "541629303",
            "country_code": "US",
            "telephone_number": "920-822-1100",
            "fax_number": "920-822-5731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Commercial St",
            "address_purpose": "LOCATION",
            "city": "Seymour",
            "state": "WI",
            "postal_code": "541658474",
            "country_code": "US",
            "telephone_number": "920-833-2318",
            "fax_number": "920-833-6883",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2714 Riverview Dr",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543136715",
            "country_code": "US",
            "telephone_number": "920-430-4760",
            "fax_number": "920-430-4774",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "441 French St",
            "address_purpose": "LOCATION",
            "city": "Peshtigo",
            "state": "WI",
            "postal_code": "541571203",
            "country_code": "US",
            "telephone_number": "715-582-9949",
            "fax_number": "715-582-4464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAUTZ",
        "first_name": "HOLLY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA - C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "VANZEELAND",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brillion, WI

Sources for this page

Verify at the official NPI Registry.